U.S. patent number 11,207,329 [Application Number 15/906,868] was granted by the patent office on 2021-12-28 for methods for treating gi syndrome and graft versus host disease.
This patent grant is currently assigned to BOARD OF REGENTS, THE UNIVERSITY OF TEXAS SYSTEM, SLOAN KETTERING INSTITUTE FOR CANCER RESEARCH. The grantee listed for this patent is Board of Regents, The University of Texas System, Sloan Kettering Institute for Cancer Research. Invention is credited to Wadih Arap, Richard N. Kolesnick, Renata Pasqualini, Jimmy Andrew Rotolo.
United States Patent |
11,207,329 |
Rotolo , et al. |
December 28, 2021 |
Methods for treating GI syndrome and graft versus host disease
Abstract
We have discovered that administering anti-ceramide antibody
treats and prevents an array of diseases mediated by cytolytic T
lymphocyte (CTLs)-induced killing and by damage to endothelial
microvasculture, including radiation-induced GI syndrome, Graft vs.
Host diseases, inflammatory diseases and autoimmune diseases. We
have also discovered new anti-ceramide monoclonal antibodies, that
have therapeutic use preferably in humanized form to treat or
prevent these diseases.
Inventors: |
Rotolo; Jimmy Andrew (Port
Washington, NY), Kolesnick; Richard N. (New York, NY),
Pasqualini; Renata (Los Ranchos de Albuquerque, NM), Arap;
Wadih (Los Ranchos de Albuquerque, NM) |
Applicant: |
Name |
City |
State |
Country |
Type |
Sloan Kettering Institute for Cancer Research
Board of Regents, The University of Texas System |
New York
Austin |
NY
TX |
US
US |
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Assignee: |
SLOAN KETTERING INSTITUTE FOR
CANCER RESEARCH (New York, NY)
BOARD OF REGENTS, THE UNIVERSITY OF TEXAS SYSTEM (Austin,
TX)
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Family
ID: |
1000006019468 |
Appl.
No.: |
15/906,868 |
Filed: |
February 27, 2018 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20190046538 A1 |
Feb 14, 2019 |
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Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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15437165 |
Feb 20, 2017 |
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13974405 |
Aug 23, 2013 |
9592238 |
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12599280 |
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8562993 |
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PCT/US2008/062789 |
May 6, 2008 |
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60916298 |
May 6, 2007 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61K
31/55 (20130101); C07K 16/44 (20130101); C07K
16/40 (20130101); C07K 16/28 (20130101); A61K
2039/505 (20130101) |
Current International
Class: |
A61K
31/55 (20060101); C07K 16/28 (20060101); C07K
16/40 (20060101); C07K 16/44 (20060101); A61K
39/00 (20060101) |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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2006-505527 |
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Feb 2006 |
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JP |
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20050014573 |
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Feb 2005 |
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KR |
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WO-2005/025489 |
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Mar 2005 |
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WO |
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WO-2006/133450 |
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Dec 2006 |
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WO |
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Other References
Cowart et al., "Structural determinants of sphingolipid recognition
by commercially available anti-ceramide antibodies," Journal of
Lipid Research, vol. 43, No. 12, pp. 2042-2048 (2002). cited by
applicant .
Fan et al., "Construction and expression of 2A2 chimeric antibody
2A2 neutralising cathepsin B activity," Anticancer Research--Int'l
J. of Cancer Res. and Treatment, Int'l Institute of Anticancer
Research, vol. 22, No. 6C, p. 4322 (Nov. 1, 2002). cited by
applicant .
Grassme et al., "CD95 signaling via ceramide-rich membrane rafts,"
Journal of Biological Chemistry, vol. 276, No. 23, pp. 20589-20596
(Jun. 8, 2001). cited by applicant .
Gulbins et al., "Physiological and pathophysiological aspects of
ceramide," Am. J. Physiol. Regul. Integr. Comp. Physiol., 290, pp.
R11-R26 (2006). cited by applicant .
Gulbins et al., "Raft ceramide in molecular medicine," Oncogene,
vol. 22, No. 45, pp. 7070-7077 (2003). cited by applicant .
International Search Report, PCT/US2008/062789 (dated Oct. 7,
2008). cited by applicant .
Kawase et al., "Increase of ceramide in adriamycin-induced HL-60
cell apoptosis: detection by a novel anti-ceramide antibody,"
Biochimica el Biophysica Acta, vol. 1584, No. 2-3, pp. 104-114
(2002). cited by applicant .
Krishnamurthy et al., "Development and characterization of a novel
anti-ceramide antibody","Journal of Lipid Research", vol. 48, No.
4, pp. 968-975 (2004). cited by applicant .
Mueller et al., "Humanized porcine VCAM-specific monoclonal
antibodies with chimeric IgG2/G4 constant regions block human
leukocyte binding to porcine endothelial cells," Mol. Immunology,
vol. 34, No. 6, pp. 441-452 (Jan. 1, 1997). cited by applicant
.
Novak et al., "Do statins have a role in preventing or treating
sepsis?," Critical Care Journal, vol. 10(1), pp. 113 (Jan. 23,
2006). cited by applicant .
Oliva-Hemker et al., "Pernicious anemia and widespread absence of
gastrointestinal endocrine cells in a patient with autoimmune
polyglandular syndrome type I and malabsorption," Journal of
Clinical Endocrinology & Metabolism, vol. 91(8), pp. 2833-2838
(May 9, 2006). cited by applicant .
Paris et al., "Endothelial apoptosis as the primary lesion
initiating intestinal radiation damage in mice," Science, vol. 293,
No. 5528, pp. 293-297 (2001). cited by applicant .
Rotolo et al., "Anti-ceramide antibody prevents the radiation
gastrointestinal syndrome in mice," Journal of Clinical
Investigation, vol. 122, No. 5, pp. 1786-1790 (May 1, 2012). cited
by applicant .
Rotolo et al., JBC, 280, pp. 26425-26434 (2005). cited by applicant
.
Stage et al., "Depression in COPD--management and quality of
life","International Journal of Chronic Obstructive Pulmonary
Disease", vol. 1, No. 3, pp. 315-320 (2006). cited by applicant
.
Vielhaber et al., "Mouse anti-ceramide antiserum: a specific tool
for the detection of endogenous ceramide," Glycobiology, vol. 11,
No. 6, pp. 451-457 (2001). cited by applicant.
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Primary Examiner: Wen; Sharon X
Attorney, Agent or Firm: Foley & Lardner LLP
Government Interests
STATEMENT OF GOVERNMENTAL INTEREST
This invention was made with government support under CA085704
awarded by the National Institutes of Health. The government has
certain rights in the invention.
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
This application is a continuation of U.S. patent application Ser.
No. 15/437,165, filed Feb. 20, 2017, which is a continuation of
U.S. patent application Ser. No. 13/974,405, filed Aug. 23, 2013,
which is a divisional of U.S. patent application Ser. No.
12/599,280, filed Nov. 6, 2009, which is a 371 national stage
application of PCT Application No. PCT/US2008/062789, filed May 6,
2008, which claims priority to U.S. Provisional Patent Application
No. 60/916,298, filed May 6, 2007, the entire contents of which are
hereby incorporated by reference as if fully set forth herein,
under 35 U.S.C. .sctn. 119(e).
Claims
What is claimed is:
1. A method of inhibiting Fas-mediated death of a cell comprising
exposing the cell to an effective amount of an inhibitor of
ceramide-rich platform (CRP) formation, wherein the inhibitor of
CRP formation is an anti-ceramide antibody or antigen binding
fragment comprising the V.sub.H CDR 1-3 and V.sub.L CDR 1-3
sequences of the 2A2 anti-ceramide antibody produced by the
hybridoma deposited under international deposit number
PTA-13418.
2. A method of inhibiting Fas-mediated death of a cell in a subject
in need thereof comprising administering an effective amount of an
inhibitor of ceramide-rich platform (CRP) formation to the subject,
wherein the inhibitor of CRP formation is an anti-ceramide antibody
or antigen binding fragment comprising the V.sub.H CDR 1-3 and
V.sub.L CDR 1-3 sequences of the 2A2 anti-ceramide antibody
produced by the hybridoma deposited under international deposit
number PTA-13418.
3. The method of claim 2, wherein the subject is a bone marrow
transplant recipient.
4. The method of claim 2, wherein the subject suffers from
graft-versus-host disease.
5. A method of inhibiting Fas-mediated death of a cell in a subject
suffering from an autoimmune disease comprising administering an
effective amount of an inhibitor of ceramide-rich platform (CRP)
formation to the subject, wherein the inhibitor of CRP formation is
an anti-ceramide antibody or antigen binding fragment comprising
the V.sub.H CDR 1-3 and V.sub.L CDR 1-3 sequences of the 2A2
anti-ceramide antibody produced by the hybridoma deposited under
international deposit number PTA-13418.
6. The method of claim 5, wherein the autoimmune disease is
graft-versus-host disease.
Description
The instant application contains a Sequence Listing which has been
submitted electronically in ASCII format in application Ser. No.
15/437,165, and is hereby incorporated by reference in its
entirety. Said ASCII copy, created on Jun. 7, 2017, is named
115872-1211_SL.txt and is 36,160 bytes in size.
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention is in the field of methods for treating and
preventing GI Syndrome and Graft Versus Host Disease.
2. Description of the Related Art
Radiation remains one of the most effective treatments for a wide
variety of malignant cells; however healthy cells of the bone
marrow, hair follicle, epidermis and gastrointestinal tract are
extremely sensitive to radiation-induced cell death, limiting the
effective use of this therapy for the treatment of cancer. Bone
marrow transplantation is another way to treat advanced cancer,
however, organ transplants frequently evoke a variety of immune
responses in the host, which results in rejection of the graft and
graft-versus-host disease (hereinafter, referred to as "GVHD").
Bone marrow transplantation is currently used to treat a number of
malignant and non-malignant diseases including acute and chronic
leukemias, myelomas, solid tumors (R. J. Jones, Curr Opin Oncol 3
(2), 234 (1991); G. L. Phillips, Prog Clin Biol Res 354B, 171
(1990)), aplastic anemias and severe immunodeficiency's (R. P.
Gale, R. E. Champlin, S. A. Feig et al., Ann Intern Med 95 (4), 477
(1981); G. M. Silber, J. A. Winkelstein, R. C. Moen et al., Clin
Immunol Immunopathol 44 (3), 317 (1987)). The conditioning regimen
required prior to transplantation, designed to ablate or suppress
the patient's immune system, renders the patient susceptible to
neoplastic relapse or infection. Recent use of unrelated and HLA
non-identical donors has unfortunately increased the incidence of
GvHD. While removal of T cells from the donor marrow graft
ameliorates GvHD, this strategy increases graft failure rates and
markedly diminishes the therapeutically-beneficial
graft-versus-tumor effect. As such, overall survival does not
improve. Further, despite strong pre-clinical data, attempts to
improve GvHD outcomes by diminishing inflammatory cytokine action
by adding TNF antagonists to corticosteroids, the standard of care
for acute GvHD, has provided limited therapeutic benefit. Thus
there is an urgent need for alternative strategies to reduce the
incidence and severity of GI syndrome and GvHD, if it is to be
optimized clinically.
DESCRIPTION OF THE DRAWINGS
FIG. 1. ASMase and Bax deficiency protect C57BL/6 intestinal mucosa
against radiation-induced microvascular endothelial apoptosis.
Proximal jejunal specimens were obtained at 4 hours after 15 Gy TBI
of wild type (second panel) and asmase.sup.-/- (third panel) and
Bax.sup.-/- (fourth panel) C57BL/6 mice, and compared with a
specimen obtained from an unirradiated wild type mouse (first
panel). Apoptotic nuclei of endothelial cells (red, CD31 stain)
were identified in the villus lamina propria by TUNEL staining as
condensed or fragmented brown nuclei contrasting with the blue
stain of non-apoptotic nuclei. Arrows indicate apoptotic
endothelial cells.
FIGS. 2A-2C. ASMase deficiency protects intestinal mucosa against
radiation-induced microvascular endothelial apoptosis and crypt
stem cell lethality. FIG. 2A: Frequency histograms of apoptotic
cells in the villus lamina propria of irradiated asmase.sup.+/+ and
asmase.sup.-/- mice at 4 hours after 0 to 15 Gy TBI assessed by
TUNEL staining. Apoptotic cells were scored in the lamina propria
of 200 villae per point. Data represent mean scores from two
experiments. FIG. 2B: Transverse sections of C3HeB/FeJ proximal
jejunum were obtained either before irradiation or at 3.5 days
after irradiation and stained with hematoxylin. Large
hyperchromatic crypts are seen in the irradiated specimens (middle
and lower panels), typical for surviving regenerating crypts, which
are significantly enlarged as compared to control unirradiated
crypts (upper panel). FIG. 2C: H&E-stained proximal jejunum and
femur sections obtained from autopsy of asmase.sup.+/+ and
asmase.sup.-/- C57BL/6 following 15 Gy TBI. The day of lethality is
noted.
FIGS. 3A-3C. Bax deficiency protects mouse intestines against
radiation-induced endothelial apoptosis, crypt lethality and the
lethal GI syndrome. C57Bl/6 mice were exposed to 15 Gy TBI (FIG.
3A) or 13-15 Gy (FIG. 3B) and tissue samples were obtained and
processed as described in FIGS. 1 and 2A-2C. Similar results were
obtained in two experiments for each response shown. Data are
reported as mean apoptotic cells in the lamina propria of 200
villae per point (shown in FIG. 3A) and mean.+-.SEM surviving
crypts from 10-20 circumferences scored for each of 4 mice (shown
in FIG. 3B). FIG. 3C: Actuarial survival curves of 8-12 week-old
C57BL/6 mice receiving autologous bone marrow transplantation
following exposure to 12-15 Gy TBI. Actuarial survival was
calculated by the product limit Kaplan-Meier method [Kaplan, 1958
#47]. 4-10 animals were irradiated per group. Data represent
collated survival results from multiple experiments.
FIGS. 4A-4B. Neutralization of Ceramide Antagonizes Platform
Generation, Attenuating Radiation-induced Apoptosis in vitro. FIG.
4A: Pre-incubation of Jurkat T cells with anti-ceramide MID15B4 (1
microgram/ml) 15 min prior to 10 Gy IR attenuated platform
generation. Platforms were quantified by bright field microscopy
following staining with anti-ceramide MID15B4 (1:30) and
Texas-Red-conjugated anti-mouse IgM (1:500). FIG. 4B: Apoptosis was
quantified in Jurkat cells by nuclear morphologic analysis
following Hoeschst bisbenzimide staining with or without
preincubation with anti-ceramide MID15B4 (1 microgram/ml). Data are
derived from minimum 150 cells obtained from three independent
experiments.
FIGS. 5A-5D. Sequestration of ceramide protects C57BL/6 intestinal
mucosa against radiation-induced microvascular endothelial
apoptosis, crypt stem cell death and lethal GI toxicity. FIG. 5A:
Crypt survival assessed by the crypt microcolony assay. Surviving
crypt were identified as shown in FIG. 4 and counted. Data for
computation of the surviving fraction at each dose level was
compiled from 2-4 animals irradiated concomitantly, with 10-20
circumferences scored per mouse. Data are reported as mean.+-.SEM.
FIG. 5B: Frequency histograms of apoptotic cells in the villus
lamina propria of irradiated asmase.sup.+/+ and asmase.sup.-/- mice
4 hours after 15 Gy TBI assessed by TUNEL staining. Apoptotic cells
were scored in the lamina propria of 200 villae per point. Data
represent collated mean scores from two experiments. FIG. 5C:
Actuarial survival curves of 8-12 week-old C57BL/6 mice
administered anti-ceramide or IgM and exposed to 15 Gy TBI.
Actuarial survival was calculated by the product limit Kaplan-Meier
method [Kaplan, 1958 #47]. 5-10 animals were irradiated per group.
Similar data were observed in 3 experiments. FIG. 5D: Pretreatment
of C57BL/6 mice with anti-ceramide MID15B4 (100 micrograms) 15 min
prior to 15 Gy TBI attenuated endothelial apoptosis compared to
control IgM treatments. Small intestine and lung tissue obtained 4
hrs following 15 Gy-irradiation were stained by TUNEL. Apoptotic
cells are indicated by brown-stained nuclei. Data (mean.+-.SEM)
were obtained from minimum 150 villi from two independent
experiments.
FIG. 6. Flow chart showing the strategy used to generate
humanizable anti-ceramide monoclonal antibody.
FIG. 7. Development of antigen (Ag), Validation of ELISA for
Screening. (Inset) BSA-conjugated ceramide was generated by
synthesizing BSA-conjugated C.sub.16 fatty acid onto a sphingoid
base. Validation of the Ag for antibody screening was performed by
ELISA assay, in which decreasing amounts of Ag were fixed to a
plate, and following blocking each well was incubated with
anti-ceramide MID15B4 antibody (1:100) followed by horseradish
peroxidase-conjugated anti-mouse IgM. OD was assessed following
administration of (horseradish peroxidase) HRP substrate at 650
nm.
FIG. 8. BSA-ceramide ELISA identified enhanced binding activity in
supernatant #3673 following immunization with Kaposi sarcoma cells.
Binding of plasma samples obtained from immunized mice by ELISA at
1:100 dilution identified higher binding of ceramide by sample
#3673 vs. #3674. Binding activity remained following
immortalization of antibody producing B cells (sn73-I-C6), enabling
the isolation of monoclonal 2A2 IgM with anti-ceramide binding
activity (not shown).
FIG. 9. Purified monoclonal 2A2 antibody binds to BSA-ceramide.
Elisa revealed that 2A2 mouse monoclonal IgM binds to BSA-ceramide.
Elisa shows significantly more binding capacity of 2A2 vs. control
IgM, performed as in FIG. 7. 2A2 binds ceramide 5-10.times. less
efficiently than MID15B4 mouse IgM.
FIG. 10. 2A2 antagonizes radiation-induced apoptosis in vitro.
Pre-incubation of Jurkat T cells with anti-ceramide 2A2 (0-100
microgram/ml) 15 min prior to 8 Gy IR. Apoptosis was quantified in
Jurkat cells by nuclear morphologic analysis following Hoeschst
bisbenzimide staining with or without preincubation with
anti-ceramide antibody. Data are derived from minimum 150 cells
obtained from three independent experiments
FIGS. 11A-11B. 2A2 Enhanced Crypt Survival Following 15 Gy in vivo.
FIG. 11A: Pretreatment of C57BL/6 mice with increasing doses of 2A2
anti-ceramide (0-750 micrograms) improves crypt survival 3.5 d
following 15 Gy TBI. FIG. 11B: 2A2 anti-ceramide antibody increases
crypt survival following 8-15 Gy total body irradiation by a
dose-modifying factor (DMF) of 1.2 (in previous studies, ASMase
deficiency increased crypt survival by a DMF of 1.2 in C57BL/6
mice). Crypt survival was determined as in FIG. 5C.
FIGS. 12A-12D. 2A2 antibody improves survival of C57BL/6 mice
exposed to 14-17 Gy single-dose radiation. C57BL/6 mice were
irradiated with 14, 15, 16, or 17 Gy TBI (as shown in FIGS. 12A,
12B, 12C, and 12D respectively) with or without 750 micrograms 2A2
15 min prior to IR. Mice were infused with 3.times.10.sup.6
autologous bone marrow cells within 16 hour of IR. Survival was
monitored and expressed via Kaplan-Meier parameters. Statistical
significance (P<0.05) was achieved at each dose.
FIG. 13. 2A2 Antibody Attenuates Radiation-induced GI death in
vivo, recapitulating the asmase.sup.-/- phenotype. Necropsy results
of mice sacrificed when moribund from survival studies performed in
FIGS. 12A-12D. GI death was assessed when proximal jejunum specimen
appear >90% denuded of crypt-villi units and crypt regeneration
is absent. Bone marrow (BM) death was assessed when decalcified
femur sections reveal depletion of hematopoietic elements and
massive hemorrhage.
FIG. 14. A cartoon illustrating the immunopathophysiology of acute
GvHD.
FIGS. 15A-15B. Host ASMase regulates graft-vs.-host-associated
morbidity and mortality. Lethally-irradiated (1100 cGy)
C57BL/6.sup.asmase+/+ or C57BL/6.sup.asmase-/- mice received
intravenous injection of LP TCD-BM cells (5.times.10.sup.6) with or
without splenic T cells (3.times.10.sup.6). Kaplan-Meier survival
and clinical GvHD score;.sup.117 derived from weekly assessment of
5 clinical parameters (weight loss, hunched posture, decreased
activity, fur ruffling, and skin lesions) are shown in FIG. 15A and
FIG. 15B respectively, representing 6-8 BM control and 13-14 BM+T
cell recipients per group compiled from two experiments.
Statistical analysis is as follows: (A) vs. .box-solid. p<0.001,
.box-solid. vs. .circle-solid. p<0.001. (B) vs. .box-solid.
p<0.05, .box-solid. vs. .circle-solid. p<0.05.
FIGS. 16A-16F. In vivo activated allogeneic CTLs require target
hepatocyte ASMase for efficient killing ex vivo. Hepatocytes,
isolated as described in Example 1, were coincubated with splenic T
cells harvested from lethally-irradiated wild type C57BL/6
recipients 10-14 days following transplantation of LP BM+T cells.
FIG. 16A: 2.times.10.sup.6 GvH-activated CTLs were coincubated with
0.5.times.10.sup.6 wild type C57BL/6 or B6.MRL.lpr (FasR.sup.-/-)
hepatocytes (left panel) in complete medium for 16 hr.
Alternatively, DMSO or concanamycin A pre-treated (100 ng/ml, 30
min) GvH-activated CTLs were coincubated with 0.5.times.10.sup.6
wild type C57BL/6 hepatocytes for 16 hr (right panel). Apoptosis
was quantified following fixation by nuclear bisbenzimide staining.
FIG. 16B: asmase.sup.-/- hepatocytes are resistant to apoptosis
induced by GvH-activated CTLs. CTL coincubation was performed as in
FIG. 16A and apoptosis was quantified 16 hr thereafter. FIG. 16C:
Representative images of asmase.sup.+/+ (top left panel) and
asmase.sup.-/- (bottom left panel) C57BL/6 hepatocytes following 10
min coincubation in suspension with 2.times.10.sup.6 GvH-activated
T cells. Hepatocytes were fixed and stained with DAPI and
Cy-3-labelled anti-ceramide mAb as described in Example 1. Arrows
indicate ceramide-rich platform generation on the outer leaflet of
the plasma membrane. Note that after incubation, cells were
centrifuged at 50.times.g for 4 min at 4.degree. C. prior to
staining and imaging. Hence CTLs (small blue nuclei) distributed
with hepatocytes (large blue nuclei) do not reflect biologic
association. FIG. 16D: Quantification of ceramide-rich platforms in
asmase.sup.+/+ and asmase.sup.-/- hepatocytes following incubation
with 2.times.10.sup.6 GvH-activated CTLs. 0.5.times.10.sup.6
hepatocytes were coincubated for the indicated times, fixed and
stained as above.
FIG. 16E: Exogenous C.sub.16-ceramide bypasses the requirement for
target cell ASMase, conferring apoptosis onto GvH-activated
CTL-stimulated asmase.sup.-/- hepatocytes. Apoptosis was quantified
as in FIG. 16A. FIG. 16F: Disruption of membrane GEMs with nystatin
inhibits CTL-induced hepatocyte apoptosis. 0.5.times.10.sup.6 wild
type hepatocytes, preincubated with 50 .mu.g/mL nystatin for 30 min
and resuspended in RPMI containing 1% lipid-free FBS, were
coincubated with 2.times.10.sup.6 GvH-activated T cells and
apoptosis was quantified as in FIG. 16A. Data (mean.+-.SEM)
represent triplicate determinations from three independent
experiments each for panels FIGS. 16A, 16B, 16D, 16E and 16F.
FIG. 17. Schematic of the in vitro mixed lymphocyte reaction (MLR)
assay.
FIG. 18. Schematic of the in vitro activation-induced cell death
(AICD) assay.
FIGS. 19A-19G. In vitro activated CTLs require target splenocyte
ASMase for efficient killing. FIG. 19A: Representative images of
ceramide-rich platforms (arrows) formed on the surface of
Mitotracker Red-labeled, conA-activated (5 mg/ml for 24 hr) target
C57BL/6.sup.asmase+/+ and C57BL/6.sup.asmase-/- splenocytes, upon
coincubation for 20 min with effector Balb/c splenic T cells that
had been activated in vitro with 2.times.10.sup.6 irradiated (2 Gy)
C57BL/6 splenocytes/ml media for 5 days at a target:effector ratio
of 2:1. Target splenocytes were fixed with 4% formalin-buffered
phosphate, and stained with DAPI and FITC-labeled anti-ceramide
mAb. FIG. 19B: Lysis of .sup.51Cr-labelled target
C57BL/6.sup.asmase+/+ and C57BL/6.sup.asmase-/- splenocytes
following coincubation with effector Balb/c splenic T cells for 6
hr measured by the chromium-release assay. FIG. 19C: Cytolytic
response of .sup.51Cr-labelled target C57BL/6.sup.asmase-/-
splenocytes to activated effector Balb/c splenic T cells as in FIG.
19B, in the presence of 500 nM C.sub.16-ceramide or
C.sub.16-dihydroceramide (DCer). FIG. 19D: Representative images of
ceramide-rich platforms (arrows) formed on the surface of
C57BL/6.sup.asmase+/+ and C57BL/6.sup.asmase-/- C57BL/6 splenic T
cells 4 hr following induction of AICD with 10 ng/ml anti-CD3 as
described in Materials and Methods. Cells were fixed with 4%
formalin-buffered phosphate, and stained with DAPI and FITC-labeled
anti-ceramide mAb. AICD induces a 2.0.+-.0.1 fold increase in the
overall ceramide signal as determined by mean fluorescence
intensity in asmase.sup.+/+ T cells (p<0.005 compared to
unstipulated controls), not evident in asmase.sup.-/- T cells,
accounting for the difference in overall staining between panels.
FIG. 19E: Confocal microscopic detection of ceramide (second panels
from top) and GM.sub.1 (third panels from top) colocalization in
platforms following AICD induction as in FIG. 19D. Platforms were
identified using Cy3-anti-mouse IgM detection of anti-ceramide
MID15B4 and FITC-conjugated cholera toxin, respectively. FIG. 19F:
Apoptotic response of C57BL/6.sup.asmase+/+ or
C57BL/6.sup.asmase-/- splenic T cells after AICD apoptotic
fratricide was induced as in FIG. 19D. Apoptosis was quantified 16
hr thereafter following nuclear bisbenzimide staining. FIG. 19G:
AICD was initiated in C57BL/6.sup.asmase-/- splenic T cells as in
FIG. 19D, in the presence of 500 nM C16-ceramide or
C.sub.16-dihydroceramide. Apoptosis was quantified 16 hr thereafter
following nuclear bisbenzimide staining. Data (mean.+-.SEM)
represent triplicate samples from three independent experiments for
panels FIGS. 19B, 19C, 19F, and 19G.
FIG. 20. 2A2 Antibody Impacts acute GvHD in vivo, partially
recapitulating the asmase.sup.-/- phenotype. Kaplan-Meier survival
analysis following transplantation of LP BM and T cells as
described in FIG. 14. The group receiving 2A2 antibody received 750
micrograms antibody 15 min prior to the first half of 1100 cGy
split-dose TBI.
FIG. 21. 2A2 Antibody Attenuates Serum Cytokine Storm Associated
with acute GvHD. Serum was harvested on day 7 following BMT from
mice undergoing experimental acute GvHD from FIG. 15. Serum
interferon-gamma was quantified by ELISA, according to
manufacturer's protocol (R&D Systems).
FIGS. 22A-22E. Host ASMase determines graft-vs.-host target organ
injury and apoptosis. C57BL/6.sup.asmase+/+ or
C57BL/6.sup.asmase-/- mice received transplants and were sacrificed
21 days thereafter for histopathologic analysis. FIG. 22A:
Representative 5 .mu.M H&E-stained liver sections showing
increased lymphocyte infiltration, portal tract expansion and
endotheliitis in asmase.sup.+/+ hosts receiving allogeneic T cells
compared to asmase.sup.-/- littermates. FIG. 22B: Representative 5
.mu.M TUNEL-stained sections of proximal jejunal crypts and villi
display lamina propria and crypt apoptosis. Arrows indicate cells
containing condensed or fragmented brown nuclei contrasting with
the blue stain of non-apoptotic nuclei, quantified in FIG. 22C and
FIG. 22D, respectively. Frequency histograms of apoptotic cells in
the villus lamina propria FIG. 22C represent data from 150 villae
per point, collated from 2 experiments. Crypt apoptosis FIG. 22D
was scored in 200 crypts per point, and represent mean.+-.SEM
collated from 2 experiments. FIG. 22E C57BL/6 recipient hosts
received marrow transplants as above, or alternatively,
10.times.10.sup.6 TCD-BM cells with or without 0.5.times.10.sup.6 T
cells from B10.BR (H2.sup.k) donors. Skin (tongue and ear) were
harvested 14 (B10.BR recipients) or 21 (LP) days post marrow
transplant and GvHD score was determined by the number of
dyskeratotic and apoptotic keratinocytes per millimeter of
epidermis (mean.+-.SEM) as assessed in blinded fashion on
H&E-stained sections. Data represent 4-14 mice per group
compiled from three independent experiments.
FIGS. 23A-23B. Donor CD8.sup.+ T cell expansion are impaired in
asmase.sup.-/- hosts. FIG. 23A: C57BL/6.sup.asmase+/+ and
C57BL/6.sup.asmase-/- recipients were infused with 15-20.sup.6
CFSE-stained splenic CD3.sup.+ T cells from LP/J donors as
described in Example 1. Spleens were harvested 72 hrs thereafter
and multicolor flow cytometry was performed. Percentage of CFSE
"high" (cells with mean fluorescent values >10.sup.3) and "low"
(mean fluorescent values <10.sup.3) CD4.sup.+ and CD8.sup.+
populations are shown from one representative of two independent
experiments. FIG. 23B: Flow cytometric analysis of Ly9.1.sup.+
donor LP/J T cells harvested from C57BL/6 asmase.sup.+/+ and
asmase.sup.-/- recipients 14 days following LP/J BM and T cell
infusion, as described in Example 1. Data (mean.+-.SEM) represent
4-12 determinations from two independent experiments.
FIG. 24. T cell proliferative capacity remains intact in
asmase.sup.-/- hosts. Thymidine incorporation assay measuring
proliferation of splenic T cells harvested from
C57BL/6.sup.asmase+/+ or C57BL/6.sup.asmase-/- recipients of donor
LP BM and T cells in response to syngeneic (LP) or allogeneic
(Balb/c) splenocytes or mitogen (ConA). Data (mean.+-.SEM)
represent triplicate determinations from three independent
experiments
FIG. 25. 1H4, 5H9 and 15D9 hybridoma cell lines were established
after six subclonings. Hybridoma supernatants were screened in a
Jurkat cell apoptosis inhibition assay and showed protective
effects that are dose dependent and comparable to 2A2. The isotypes
of the three antibodies have been established. 15D9 mAb is IgM,
kappa. 1H4 and 5H9 mAbs are mIgG3, kappa.
LIST OF ABBREVIATIONS
ASMase--acid sphingomyelinase BMT--bone marrow transplant
CTLs--cytotoxic T lymphocytes
ERK--extracellular signal-related kinase
FADD--Fas-associated death domain FcR.gamma.II--Fc receptor
.gamma.II
FITC--fluorescein isothiocyanate
GVHD--Graft-Versus-Host-Disease GVT--Graft-Versus-Tumor
IL--interleukin
JNK--c-Jun N-terminal kinase
mHAg(s)--minor histocompatability antigen(s)
MHC--major histocompatability complex MLR--mixed lymphocyte
reaction
SDS-PAGE--sodium dodecyl sulfate-polyacrylamide gel electrophoresis
TCR--T cell receptor
TNF--tumor necrosis factor
TUNEL--terminal dUTP nick-end labeling
DETAILED DESCRIPTION
We have discovered that administering anti-ceramide antibody treats
and prevents an array of diseases mediated by cytolytic T
lymphocyte (CTLs)-induced killing and by damage to endothelial
microvasculture, including radiation-induced GI syndrome, Graft vs
Host diseases, inflammatory diseases and autoimmune diseases
(herein the enumerated diseases). We have also discovered a new
anti-ceramide monoclonal antibody 2A2 and others described below,
that have therapeutic use preferably in humanized form to treat or
prevent the enumerated diseases. Identified as Myeloma cell fused
with spleen cells from Balb/c mouse: 2A2.1.1.1.1, the submission
was deposited as ATCC Deposit No. PTA-13418 on Jan. 9, 2012. The
ATCC number referred to above is directed to a biological deposit
with the ATCC, 10801 University Boulevard, Manassas, Va.
20110-2209. The strain referred to is being maintained under the
terms of the Budapest Treaty and will be made available to a patent
office signatory to the Budapest Treaty. Other embodiments of the
invention are directed to combination therapy to treat or prevent
the above enumerated diseases by administering anti-ceramide
antibody together with one or more statins; or with imipramine or
other ASMase inhibitor or Bax inhibitor. Yet other embodiments
include administering an antisense nucleotides or small interfering
RNA in an amount that reduces expression of ASMase, Bax and Bak or
otherwise reduces or ameliorates a symptom of any of the enumerated
diseases. Finally, certain embodiments are directed to compositions
for therapeutic use in treating or preventing the enumerated
diseases that include an anti-ceramide antibody and one or more
statins or imipramine.
Extracellular Ceramide is Required for Radiation-Induced
Apoptosis
Lipid rafts, which are distinct plasma membrane microdomains
comprised of cholesterol tightly packed with sphingolipids, in
particular sphingomyelin, creating a liquid-ordered domain within
the liquid-disordered bulk plasma membrane. Rafts differ in their
protein and lipid composition from the surrounding membrane,
housing signaling molecules including multiple
glycosylphosphatidylinositol (GPI)-anchored proteins,
doubly-acylated tyrosine kinases of the Src family and
transmembrane proteins. In addition, rafts serve as sites that
multiple receptors translocate into or out of upon their
activation, including the B cell receptor (BCR) upon encountering
antigen. Recent evidence suggests that these translocation events
are crucial for multiple signal transduction cascades.
Sphingolipids, which were classically viewed as structural
components of cell membranes, were discovered to be important
regulators of signal transduction by the determination that
1,2-diacylglycerols stimulated sphingomyelin hydrolysis to
ceramide.sup.5 By identifying activation of an acidic
sphingomyelinase (ASMase) that generates ceramide in GH3 pituitary
cells, these studies introduced a potential role for ceramide as a
second messenger. This role was supported by the identification of
modulated protein phosphorylation events and kinase activity in
vitro by addition of exogenous ceramides (R. N. Kolesnick and M. R.
Hemer, J Biol Chem 265 (31), 18803 (1990), S. Mathias, K. A.
Dressler, and R. N. Kolesnick, Proc NatlAcad Sci USA 88 (22), 10009
(1991)). Ultimately, the coupling of tumor necrosis factor receptor
(TNFR) activation with ceramide generation in a cell free system,
antagonism of TNF-.alpha.-mediated signaling by inhibition of
ceramide generation, and the recapitulation by exogenous ceramides
of TNF-.alpha. signaling in cells devoid of ceramide generation
established ceramide as a bonafide lipid second messenger (K. A.
Dressler, S. Mathias, and R. N. Kolesnick, Science 255 (5052), 1715
(1992)).
Acid sphingomyelinase (ASMase) is a sphingomyelin-specific
phospholipase C (sphingomyelin phosphodiesterase) that exists in
two forms, a lysosomal and secretory form; it initiates a rapid
stress response in many cell types (R. Kolesnick, Mol Chem
Neuropathol 21 (2-3), 287 (1994); J. Lozano, S. Menendez, A.
Morales et al., J Biol Chem 276 (1), 442 (2001); Y. Morita, G. I.
Perez, F. Paris et al., Nat Med 6 (10), 1109 (2000); F. Paris, Z.
Fuks, A. Kang et al., Science 293 (5528), 293 (2001); Santana, L.
A. Pena, A. Haimovitz-Friedman et al., Cell 86 (2), 189 (1996)).
Our recent work showed that clustering of plasma membrane lipid
rafts into ceramide-enriched platforms amplify stimuli capable of
activating ASMase. Grassme et al., J Biol Chem. 2001, 276:20589,
incorporated herein by reference. In these studies we showed that
in vitro and in vivo, extracellularly orientated ceramide, released
upon CD95-triggered translocation of ASMase to the plasma membrane
outer surface, enabled clustering of CD95 in sphingolipid-rich
membrane rafts and induced apoptosis in Jerkat cells. Whereas
ASMase deficiency, destruction of rafts, or neutralization of
surface ceramide prevented CD95 clustering and apoptosis, natural
ceramide rescued ASMase deficient cells. The data showed that
CD95-mediated clustering by ceramide is a prerequisite for
signaling and apoptotic cell death. Jurkat cells are a human T cell
leukemia cell line.
Others have shown that ceramide is required for Fas-induced
apoptosis in some cell types. We looked at the requirement for
UV-C-induced ceramide generation in initiating the apoptotic
response. By UV-C is meant ultraviolet radiation in the 100-280 nm
wavelength range. In these studies imipramine was used to inhibit
ASMase-activity. Pre-treatment of Jurkat cells with 50 mM
imipramine for 30 min decreased baseline ASMase activity, abrogated
UV-C and Fas-induced ASMase activation at 1 min post stimulation
and ceramide generation at 2 minutes, and attenuated apoptosis at 4
hours post-stimulation. These data showed that ASMase activation is
indispensable for optimal Fas- or UV-C-induced apoptosis, though
they do not define the role of ceramide per se in this response.
Grassme et al., J Biol Chem. 2001, 276:20589, incorporated herein
by reference.
Ceramide has important roles in differentiation, proliferation and
growth arrest, but the most prominent role for ceramide is in the
induction of programmed cell death. Exogenous C.sub.8 ceramide and
sphingomyelinase mimicked TNF-.alpha.-induced DNA fragmentation and
loss of clonogenicity in HL60 human leukemia cells, suggesting that
ceramide was an essential component of apoptotic signaling (K. A.
Dressler, S. Mathias, and R. N. Kolesnick, Science 255 (5052), 1715
(1992). Ionizing radiation (IR) stimulates sphingomyelin hydrolysis
to ceramide, and exogenous ceramide was able to bypass phorbol
ester-mediated inhibition of radiation-induced ceramide generation
and apoptosis (A. Haimovitz-Friedman, C. C. Kan, D. Ehleiter et
al., J Exp Med 180 (2), 525 (1994)). Lymphoblasts derived from
Niemann-Pick patients, a genetic disease characterized by an
inherited deficiency in ASMase activity, proved in a genetic model
that ASMase-mediated ceramide generation is required for
radiation-induced apoptosis, and the development of an
ASMase-deficient mouse allowed the identification of cell-type
specific roles for ceramide (J. Lozano, S. Menendez, A. Morales et
al., J Biol Chem 276 (1), 442 (2001); P. Santana, L. A. Pena, A.
Haimovitz-Friedman et al., Cell 86 (2), 189 (1996)). Ceramide
generation has since been identified as requisite for multiple
cytokine-, virus/pathogen-, environmental stress-, and
chemotherapeutic-induced apoptotic events. Verheij M, et al.
Requirement for ceramide-initiated SAPK/JNK signaling in
stress-induced apoptosis. Nature. 1996 Mar. 7; 380(6569):75-9;
Riethmuller J, et al., Membrane rafts in host-pathogen
interactions, Biochim Biophys Acta. 2006 December:
1758(12):2139-47, incorporated herein by reference.
An emerging body of evidence has since recognized ceramide-mediated
raft clustering as sites of signal transduction for bacteria and
pathogen internalization, and radiation- and
chemotherapeutic-induced apoptosis. D. A. Brown and E. London, Annu
Rev Cell Dev Biol 14, 111 (1998): J. C. Fanzo, M. P. Lynch, H. Phee
et al., Cancer Biol Ther 2 (4), 392 (2003); S. Lacour, A. Hammann,
S. Grazide et al., Cancer Res 64 (10), 3593 (2004); Semac, C.
Palomba, K. Kulangara et al., Cancer Res 63 (2), 534 (2003; A. B.
Abdel Shakor, K. Kwiatkowska, and A. Sobota, J Biol Chem 279 (35),
36778 (2004); H. Grassme, V. Jendrossek, J. Bock et al., J Immunol
168 (1), 298 (2002); M. S. Cragg, S. M. Morgan, H. T. Chan et al.,
Blood 101 (3), 1045 (2003);.sup.6 D. Scheel-Toellner, K. Wang, L.
K. Assi et al., Biochem Soc Trans 32 (Pt 5), 679 (2004).; D.
Delmas, C. Rebe, S. Lacour et al., J Biol Chem 278 (42), 41482
(2003).; and C. Bezombes, S. Grazide, C. Garret et al., Blood 104
(4), 1166 (2004).
In this context, ceramide-enriched platforms transmit signals for
IR-induced apoptosis of Jurkat cells (Zhang and Kolesnick,
unpublished results) and bovine aortic endothelial cells (Stancevic
and Kolesnick, unpublished results), CD40-induced IL-12 secretion
and c-Jun Kinase phosphorylation in JY B cells, P. aeruginosa
internalization and activation of the innate immune response in
lung, Rituximab-induced CD20 clustering and ERK phosphorylation in
Daudi and RL lymphoma cells, FcR.gamma.II clustering and
phosphorylation in U937 human monocytic cells, and resveratrol-,
cisplatin- and reactive oxygen species-induced apoptosis in HT29
human colon carcinoma cells and neutrophils. Despite extensive
studies on the downstream effects of ASMase translocation and
activation, little was known of the initiating events mediating its
translocation onto the outer plasma membrane until we showed that
there is a capsase-independent pathway that initiates ASMase
signaling. J. A. Rotolo et al., J. Biol. Chem. Vol 280, No. 29,
Issue of Jul. 15, 26425-34 (2005), incorporated herein by
reference.
It is important to emphasize that there are multiple pathways in a
cell to make ceramide in different compartments. Ceramide generated
at the cell surface in rafts by ASMase is different from ceramide
inside the cell. The results presented below show for the first
time that ASMase-generated cell surface ceramide is responsible for
causing radiation-induced GI syndrome through damage to endothelial
microvasculature (a hallmark of GI syndrome). We further show that
ASMase-generated ceramide is required for GVHD caused by T-cell
mediated killing. Thus ASMase generated ceramide is required for
both endothelial microvasculature damage and T-cell mediated
killing. We have further discovered that inhibiting or sequestering
ceramide generated by ASMase by administering anti-ceramide
antibodies in vivo, reduced radiation-induced damage, and can be
sued to treat or prevent GI syndrome and GvHD. Certain embodiments
of the present invention are directed to pharmacological methods to
treat or prevent GVHD and GI syndrome and other T-cell mediated
diseases including autoimmune diseases, by blocking ASMase (for
example with imipramine or with antisense nucleic acids) or by
inactivating cell surface ceramide (for example with anti-ceramide
antibodies alone or together with statins).
Treatment and Prevention of the Lethal GI Syndrome
The intestinal clonogenic compartment housing stem cells of the
small intestine resides at positions 4-9 from the bottom of the
crypt of Lieberkuhn, and consists of intestinal pluripotent stem
cells and uncommitted progenitor clonogens, herein called stem cell
clonogens. This group of cells proliferates and differentiates
incessantly, replenishing the physiologic loss of enterocytes and
other differentiated epithelial cells from the villus apex, thus
maintaining the anatomical and functional integrity of the mucosa.
A complete depletion of this compartment appears required to
permanently destroy the crypt-villus unit, while surviving stem
cell clonogens, albeit even one per crypt, are capable of
regenerating a fully functional crypt.
Radiation targets both the gastrointestinal microvasculature and
proliferating crypt stem cells. Apoptosis of the microvascular
endothelium in the villus represents the primary lesion of the GI
syndrome, occurring 4 hours following radiation. Endothelial
apoptosis converts lesions to the crypt clonogens from sublethal to
lethal, resulting in loss of regenerative crypts and promoting GI
toxicity. Immunohistochemical and labeling studies with
[.sup.3H]TdR and BrdUrd revealed that crypt stem cell clonogen
death does not occur acutely after radiation exposure. Rather, the
earliest detectable response is a temporary dose-dependent delay in
progression through a late S-phase checkpoint and mitotic arrest,
apparently signaled by radiation-induced DNA double strand breaks
(dsb). In mammalian cells, DNA dsbs activate pathways of DNA damage
recognition and repair, and a coordinated regulation of cell cycle
checkpoint activity. The intestinal stem cell mitotic arrest
appears to represent a regulated event in this pathway. Consistent
with this notion, no significant change in crypt number per
intestinal circumference is apparent at this stage although crypt
size progressively decreases due to continued normal migration of
crypt transit and differentiated cells from the crypt into the
epithelial lining of the villus. Resumption of mitotic activity at
36-48 hours is associated with a rapid depletion of crypt stem cell
clonogens and reduction in the crypt number per circumference. The
mechanism of stem cell depletion has not been fully
established.
The lethality of GI stem cell clonogens is best assessed by the
number of crypts surviving at 3.5 days after radiation exposure,
which decreases exponentially as the dose increases (C. S. Potten
and M. Loeffler, Development 110 (4), 1001 (1990), H. R. Withers,
Cancer 28 (1), 75 (1971), and J. G. Maj, F. Paris, A.
Haimovitz-Friedman et al., Cancer Res 63, 4338 (2003)). Crypts that
contain surviving stem cells proliferate at an accelerated rate,
producing typical regenerative crypts that split or bud to generate
new crypts, until the intestinal mucosa regains a normal
architecture. TBI experiments in several mouse models have
demonstrated that the number of surviving crypt stem cells after
exposure to 8-12 Gy is usually sufficient to support a complete
recovery of the mucosa. At higher doses, however, massive stem cell
clonogen loss may lead to a near total collapse of the crypt-villus
system, mucosal denudation and animal death from the GI syndrome.
The threshold dose for inducing the GI death, and the TBI dose
producing 50% GI lethality (LD.sub.50), appear to be
strain-specific. Autopsy studies of C57BL/6 mice exposed to TBI
revealed that 25% of the mice exposed to 14 Gy and 100% of those
exposed 15 Gy succumbed to the GI syndrome at 6.8.+-.0.99 days,
predicting an LD.sub.50 for GI death between 14 and 15 Gy. In
contrast, the reported LD.sub.50/6 (the LD.sub.50 at day 6, serving
as a surrogate marker for GI death) for BALB/c mice is 8.8.+-.0.72
Gy, 11.7.+-.0.22 Gy for BDF1 mice, 12.5.+-.0.1 Gy for C3H/He mice,
14.9 Gy (95% confidence limits 13.9-16.0 Gy) for C3H/SPF mice, and
16.4.+-.1.2 Gy for B6CF1 mice, indicating a strain-specific
spectrum in mouse sensitivity to death from the GI syndrome. Strain
variations in the sensitivity of other organs to radiation, such as
the bone marrow and lung have also been reported.
Classically, ionizing radiation (IR) was thought to kill cells by
direct damage to genomic DNA, causing genomic instability and
resulting in reproductive cell death. Haimovitz-Friedman et al.
demonstrated in a nuclei-free system that apoptotic signaling can
alternately be generated by the interaction of IR with cellular
membranes. Extension of these studies by us and described herein
revealed that ceramide mediated raft clustering is involved in
IR-induced apoptosis and clonogenic cell death. It has long been
accepted that the clonogenic compartment of the gastrointestinal
(GI) mucosa is the specific and direct target for radiation in
inducing GI damage.
In some of our early work we showed that greater protection against
ultra violet radiation with UV-C (5-50 J/m.sup.2)- and anti-Fas
(1-50 ng/ml CH-11)-induced apoptosis in vitro was obtained by
inducing ceramide neutralization with anti-ceramide monoclonal
antibody combined with cholesterol depletion induced by nystatin in
Jurkat cells, than was obtained using either agent alone. H.
Grassme, H. Schwarz, and E. Gulbins, Biochem Biophys Res Commun 284
(4), 1016 (2001), incorporated herein by reference. In these
studies we showed that preincubation of Jurkat cells with
anti-ceramide antibody in combination with nystatin inhibited raft
clustering 1 min post 50 J/m.sup.2 UV-C- or 50 ng/ml anti-Fas
stimulation. Furthermore, inhibiting raft clustering by
anti-ceramide and nystatin combination treatment attenuated UV-C
(5-50 J/m.sup.2)- and anti-Fas (1-50 ng/ml CH-11)-induced apoptosis
4 hours post stimulation (FIG. 2d) and enhanced cell viability by
2.46- and 2.42-fold, respectively, 7 days post stimulation with 50
J/m.sup.2 UV-C or 50 ng anti-Fas. Importantly, we also observed
that anti-ceramide and nystatin pretreatment yielded an approximate
1 log increase in clonogenic cell survival compared to vehicle
controls after 5-50 J/m.sup.2 UV-C or anti-Fas stimulation.
Plotting these clonogenic survival data according to the single-hit
multitarget model revealed that pretreatment with anti-ceramide and
nystatin increased the D.sub.0 of the dose response curve from
1.6.+-.0.7 J/m.sup.2 to 3.6.+-.1.1 J/m.sup.2, indicating
significant (p<0.05) protection against the reproductive mode of
UV-induced cell death, with a dose modifying value of 2.32 at the
10% survival level. Taken together, these results showed that
ceramide-mediated raft clustering at the surface of Jurkat cells is
obligate for apoptotic transmembrane signal transduction induced by
UV-C, and that such protection is biologically-relevant as
evidenced by improved clonogenic survival.
There is evidence for a conditional linkage between crypt stem cell
clonogen lethality after single-dose radiation and the early wave
of ASMase-mediated apoptosis in the endothelium of the intestinal
microvascular system. Radiation induces rapid translocation of a
secretory non-lysosomal form of ASMase into glycosphingolipid- and
cholesterol-enriched rafts in the outer leaflet of the plasma
membrane (E. Gulbins and R. Kolesnick, Oncogene 22 (45), 7070
(2003) where ceramide is rapidly generated, coordinating
transmembrane signaling of apoptosis. Endothelial cells are 20-fold
enriched in secretory ASMase compared with other cells in the body,
and this cell type is particularly sensitive to radiation-induced
apoptosis in vitro and in vivo. Genetic inactivation of ASMase in
SV129/C57BL/6 mice, or intravenous treatment of C57BL/6 mice with
the endothelial cell survival factor bFGF prior to whole body
irradiation (TBI), attenuated radiation-induced endothelial
apoptosis of the intestinal microvascular system, preserved crypt
stem cell clonogens, and protected mice against lethality from the
GI syndrome (F. Paris, Z. Fuks, A. Kang et al., Science 293 (5528),
293 (2001)). Given that the intestinal endothelium but not crypt
epithelial cells expressed bFGF receptor transcripts before or
after irradiation, vascular dysfunction appeared critical for
radiation-induced GI damage.
ASMase- and Bax-Deficiency Protects Against Radiation Damage and GI
Syndrome
This section describes our experiments showing that both
asmase.sup.-/- and Bax.sup.-/- mice are resistant to endothelial
apoptosis occurring within 4 hours of total body irradiation (TBI).
This allows the repair of sublethal lesions incurred by crypt
clonogens, regenerating the crypt-villus system and abrogating the
lethal GI syndrome. The well-characterized parameters of the GI
syndrome make this system an ideal model for study of ceramide
targeting pharmaceuticals. Below we show that anti-ceramide
antibody attenuated microvascular apoptosis to the level similar to
that of the asmase.sup.-/- genotype, promoting clonogenic crypt
stem cell survival and GI regeneration. Anti-ceramide protected 60%
of mice receiving 15 Gy TBI and syngeneic BMT, demonstrating that
the microvascular protection is biologically relevant.
Previous studies identified an endothelial-stem cell clonogen
linkage in the GI radiation response of the C57BL/6 mouse strain
and its SV129/C57BL/6 hybrid. Further, these studies characterized
the role of ASMase in the GI radiation response in the
SV129/C57BL/6 hybrid strain. F. Paris, et al. supra. To examine
whether genetic inactivation of ASMase protects C57BL/6 from the
vascular component in the intestinal response to radiation, several
of the features that characterize the SV129/C57BL/6 mice intestinal
response to radiation were evaluated in asmase.sup.+/+ and
asmase.sup.-/- C57BL/6 mice. Typical histologic examples of the
pattern of endothelial response to radiation in asmase.sup.+/+ and
asmase.sup.-/- genotypes in this strain are shown (FIG. 1).
Consistent with published observations on SV129/C57BL/6 mice, wild
type C57BL/6 mice show extensive endothelial apoptosis at 4 hours
after 15 Gy TBI (12 apoptotic endothelial nuclei in the villus
lamina propria; FIG. 1 second panel), reduced in the asmase.sup.-/-
and Bax.sup.-/- specimen to 3 apoptotic nuclei each (FIG. 1, third
and fourth panel, respectively). Only occasional (1-3) apoptotic
nuclei were observed in the lamina propria of an unirradiated
control asmase.sup.+/+ (FIG. 1, first panel), asmase.sup.-/- or
Bax.sup.-/- (not shown). Endothelial cell apoptosis was detected in
the wild type mucosa as early as at 3 hours after exposure to 15 Gy
and reached a maximum at 4 hours (not shown). FIG. 2 A displays a
frequency histogram of apoptotic nuclei in the intestinal lamina
propria of C57BL/6 mice at 4 hours after exposure to escalating
doses of TBI. A maximal effect was observed in the asmase.sup.+/+
mucosa at 15 Gy, with 92% of the villae displaying >3 apoptotic
nuclei/villus and 52% displaying extensive apoptosis (>10
apoptotic nuclei/villus), compared to .ltoreq.3 apoptotic
nuclei/villus observed in control unirradiated mice (p<0.001;
n=200 villae from 2 animals counted for each data point). ASMase
deficiency significantly reduced the overall apoptotic response
(>3 apoptotic nuclei/villus) to 38% and the frequency of
extensive apoptosis to 20% of the total villae (p<0.001 each
compared to wild type littermates, respectively; n=200 villae from
2 animals counted for each data point). Thus, the kinetics and
dose-dependency of radiation-induced endothelial cell apoptosis in
the C57BL/6 strain, and the requirement for ASMase, were
qualitatively and quantitatively similar to those in the
SV129/C57BL/6 mouse strain.sup.1 although the peak incidence of the
apoptotic response occurred 1 hour later than in the SV129/C57BL/6
strain.
As reported for SV129/C57BL/6 mice (J. G. Maj, F. Paris, A.
Haimovitz-Friedman et al., Cancer Res 63, 4338 (2003)), endothelial
apoptosis closely correlated with survival of crypt stem cell
clonogens after TBI. FIG. 2b shows typical cross sections of
C57BL/6 mice proximal jejunum at 3.5 days after exposure to 15 Gy
TBI. When unirradiated, the number of crypts/intestinal
circumference in this strain was 155.+-.1.1. After exposure to 15
Gy, a specimen from a C57BL/6.sup.asmase+/+ mouse shown contained
only 3 surviving regenerating crypts, compared with 27 in the
specimen obtained from a C57BL/6.sup.asmase-/- littermate. ASMase
deficiency significantly increased the crypt surviving fraction at
each dose within the range of 10-15 Gy (p<0.05). Wild type mice
3.5 days following exposure to 15 Gy TBI are nearly completely
depleted of functional proximal jejunal crypts (FIG. 2b, middle
panel). Genetic inactivation of ASMase enhanced crypt survival as
evidenced by increased expression of dark-purple stained
regenerative, hyperchromatic crypts (FIG. 2b, bottom panel). The
dose required to produce an isoeffect of 10% crypt survival
(D.sub.10) was 14.6.+-.0.9 Gy for wild-type and 16.8.+-.1.8 Gy for
the ASMase-deficient mice (p<0.01), indicating a dose-modifying
factor (DMF) of 1.15.+-.0.14 for the asmase.sup.-/- genotype. This
value was not different significantly from the DMF reported for
protection of irradiated C57BL/6 crypt stem cell clonogens by
bFGF.sup.7.
The stem cell clonogen protection afforded by ASMase deletion also
translated into protection against C57BL/6 mouse death from the GI
syndrome after 15 Gy TBI, similar to that reported for hybrid
SV129/C57BL/6asmase-/- mice1. By contrast p53-deficient C57BL/6
mice were not protected from radiation damage (data not shown.)
C57BL/6asmase+/+ mice died at 5-6 (mean 5.3.+-.0.2) days after TBI
(not shown). Autopsies revealed intestinal damage typical of the GI
syndrome (extensive denudation of nearly all the crypts and villae)
with only partial damage to the bone marrow (regions of hemorrhage
and depletion of hematopoietic elements mixed with islands of
normal hematopoietic tissue; FIG. 2c left and right middle panels,
respectively;). Other organs were found intact, except for thymic
and lymphatic tissues, and occasional micro-abscesses or focal
hemorrhages in various organs, not considered as direct causes of
death. In contrast C57BL/6.sup.asmase-/- mice died at 7.75.+-.0.12
days (p<0.001 when compared to C57BL/6.sup.asmase+/+ mice).
Autopsies revealed typical characteristics of bone marrow death
(widespread hemorrhage and extensive necrosis of the matrix, with
complete depletion of hematopoietic elements; FIG. 2c, right lower
panel). Further, in contrast to the complete destruction of the
crypt/villus network in C57BL/6.sup.asmase+/+ mice, the intestinal
mucosa of C57BL/6.sup.asmase-/- littermates showed extensive
regenerative activity with hyperplastic, chromophilic crypts
covering most of the intestinal surface (FIG. 2c, left lower
panel).
Bax Deficiency Phenocopies Asmase.sup.-/- Protection from Radiation
Damage and GI Syndrome
To eliminate the possibility that an event other than endothelial
cell apoptosis, induced by radiation and regulated by ASMase, might
impact the lethality of radiation-injured stem cell clonogens.
Experiments were carried out with the apoptosis-refractory
Bax-deficient C57BL/6 mice that express wild-type ASMase and mimic
the asmase.sup.-/- radiation phenotype in tumor endothelium an in
oocytes of young mice. Bax and Bak are prototypical proapoptotic
Bcl-2 multidomain proteins. Double deletions (homozygous recessive
Bax-/- and Bak-/- mutations) were previously believed to be
required to endow resistance to apoptotic stimuli. Data for Bak-
deficient mice is not shown.
The wild type C57BL/6.sup.Bax+/+ strain used in these experiments
displayed no detectable baseline endothelial cell apoptosis, and
underwent a time-dependent increase after exposure to 15 Gy TBI
that peaked at 4 hours (not shown). 85% of the villae contained
>3 endothelial apoptotic nuclei/villus at 4 hours after 15 Gy,
and 38% showed an extensive (>10 apoptotic nuclei/villus)
apoptotic response (FIG. 3). Bax deficiency significantly reduced
the overall radiation-induced apoptotic response to 45%
(p<0.05), and the frequency of extensive apoptosis to 12% of the
villae (p<0.001; n=200 villae from 2 animals counted for each
data point), mimicking the previously reported asmase.sup.-/-
radiation-response phenotype in C57BL/6 and SV129/C57BL/6.
Attenuation of endothelial apoptosis by Bax deficiency protected
crypt clonogens following exposure to 13, 14 and 15 Gy TBI (FIG.
3b). Surviving crypts in wild type C57BL/6 mice at 3.5 days
following 13, 14 and 15 Gy TBI, reputedly a measure of surviving
crypt stem cells, was decreased from 152.+-.3 in unirradiated
intestinal circumferences to 20.5.+-.1.3, 10.8.+-.0.6 and
2.3.+-.0.3 respectively (surviving fractions of 13.4.+-.0.9%,
7.0.+-.0.4% and 1.47.+-.0.2%, respectively, n=10-20 circumferences
each from 4 animals per point). Bax deficiency increased the number
of surviving crypts following 13, 14 and 15 Gy TBI vs. wild type
controls to 42.3.7.+-.2.0, 27.6.+-.1.6 and 18.2.+-.1.3,
respectively (surviving fractions of 27.8.+-.1.4%, 18.2.+-.1.1% and
12.0.+-.0.9%, respectively, P<0.001 vs. wild type C57BL/6, FIG.
3b). The fraction of surviving crypts in C57Bl/6.sup.Bax-/- mice
following 13-15 Gy exceeded the 8.5.+-.0.1% surviving crypts
reported necessary to support mucosal recovery and prevent GI death
in wild type C57Bl/6 mice treated with 12 Gy alone.sup.62,71. These
data are consistent with the notion of a linkage between
endothelial apoptosis and survival of crypt stem cell clonogens
after radiation exposure. J. A. Rotolo, et al, Int. J. Radiation
Oncology Biol. Phys., Vol. 70, No. 3, 804-815(2008), incorporated
herein by reference.
The stem cell clonogen protection provided by Bax deletion was
associated with protection against mouse death from the GI
syndrome, similar to that reported for SV129/C57BL/6 mice.sup.1.
Autologous bone marrow transplantation (BMT) protected 100% of
C57Bl/6.sup.Bax+/+ and C57Bl/6.sup.Bax-/- mice exposed to 13 Gy TBI
from BM death (FIG. 3c). Control animals exposed to these TBI doses
but not receiving BMT succumbed to BM death with fully repaired (12
Gy) or near completely repaired (13 Gy) GI mucosa (Table 1). Table
1 shows that genetic inactivation of Bax or pharmacologic
antagonism of ceramide by anti-ceramide antibody inhibits the
lethal GI syndrome. Autopsies of total body irradiated C57BL/6 mice
of Bax.sup.+/+ or Bax.sup.-/- genotype and C57BL/6 mice
administered anti-ceramide antibody or irrelevant IgM control
revealed Bax and ceramide signaling are required for the lethal GI
syndrome. BM and GI lethality was assessed by histopathologic
examination of H&E stained, 5 .mu.m sections of proximal
jejunum and femur. GI lethality was characterized by complete
denudation of villus and crypts, and BM lethality was characterized
by depletion of hematopoietic elements from the BM cavity and
massive hemorrhage. * denotes accelerated BM aplasia and mixed BM
and GI death.
TABLE-US-00001 TABLE 1 Lethal Syndrome Genotype TBI BM GI
C57BL/6.sup.Bax+/+ 12 Gy 100% -- 13 Gy 100% -- 14 Gy 90% 10% 15 Gy
-- 100% C57BL/6.sup.Bax-/- 12 Gy 100% -- 13 Gy 100% -- 14 Gy 100%*
-- 15 Gy 100%* -- C57BL/6 + IgM 15 Gy -- 100% C57BL/6 + 15 Gy 100%
-- anti- ceramide
A switch to death from the GI syndrome occurred in
C57Bl/6.sup.Bax+/+ mice at 14 Gy TBI, with 90% of BMT-untreated
mice succumbing to this mode of death at 7.7.+-.0.8 days (FIG. 5c;
Table 1). Thus, the C57BL/6 substrain harboring the Bax.sup.-/-
genotype exhibited an approximate 1 Gy increase in GI
radiosensitivity compared to previously reported data for a
wild-type C57BL/6 mouse colony (F. Paris, Z. Fuks, A. Kang et al.,
Science 293 (5528), 293 (2001)). Bax deficiency protected from GI
death after 14 Gy TBI (FIG. 5c, Table 1), with autopsies showing
hyperplastic, chromophilic crypts covering most of the intestinal
surface, indicative of advanced regeneration of the intestinal
mucosa, and typical changes of BM death. These findings are
consistent with the levels of crypt stem cell clonogen survival in
C57Bl/6.sup.Bax-/- mice reported above (FIG. 3b) and the
observation of a regenerating intestinal mucosa is probably
associated with prolongation of survival of these mice (8.4.+-.0.5
days; Table 1), which presumably enabled initiation of mucosal
recovery. Autologous BMT permanently rescued 60% of
C57Bl/6.sup.Bax-/- mice exposed to 14 Gy TBI (FIG. 3c; p<0.05),
while the remaining animals failed engraftment and succumbed to
bone marrow aplasia (Table 1). When the dose was escalated to 15 Gy
TBI, C57Bl/6.sup.Bax+/+ mice died at 5.5.+-.0.4 days from
autopsy-proven mixed GI and BM death (Table 1) and Bax deficiency
failed to rescue the animals, despite the apparent availability of
sufficient numbers of surviving crypts (FIG. 3b) as required for
successful recovery of the GI mucosa. The latter phenomenon likely
resulted from an accelerated development of BM aplasia and BM
death, due to reasons uncertain, which occurred before mucosal
regeneration became apparent. Consistent with this notion,
autologous BMT into 15 Gy TBI-treated C57Bl/6.sup.Bax-/- mice
extended mice survival to 9.0.+-.0.0 days (FIG. 3c; p<0.05), and
although the level of engraftment was insufficient to rescue the
mice from BM matrix necrosis and complete depletion of
hematopoietic elements (Table 1 and not shown), the intestinal
mucosa revealed multiple areas of actively regenerating crypts.
These data indicate that Bax deficiency mimics the protection
against GI lethality conferred by ASMase deficiency. It should be
noted that Bax and Bak deficiencies did not impact the p53 mediated
epithelial apoptosis at crypt positions 4-5. Moreover, Bax and Bak
do not overlap functionally in the intestinal microvascular system.
Additional support can be found in J. A. Rotolo, et al, Int. J.
Radiation Oncology Biol. Phys., Vol. 70, No. 3, 804-815(2008),
incorporated herein by reference.
Certain embodiments of the invention are directed to methods for
treating or preventing radiation damage or GI syndrome (and the
other enumerated diseases that are discussed below) in a subject by
administering an antisense nucleotide or siRNA that inhibits the
endogenous expression of the target protein ASMase or Bak or Bax in
the patient. Other embodiments are directed to methods to treat or
prevent radiation disease or GI syndrome by administering
imipramine in amounts that ameliorate one or more symptoms of the
disease. A therapeutic amount of antisense that inhibits ASMase for
example, or imipramine can be determined by routine experimentation
as an amount that reduces ASMase activity or expression in a
biological sample from a human (or mammalian) subject compared to
pretreatment levels.
The respective antisense nucleotide is one wherein at least a
portion of the antisense nucleotide, typically 8-50 consecutive
nucleotides) is complementary to and specifically hybridizes with
the gene or mRNA encoding the target ASMase, Bax or Bak. The
GenBank accession number for ASMase is NP_000534, incorporated
herein as SEQ ID NO: 1. The GenBank accession number for Bax is
NP_004315.1, incorporated herein as SEQ ID NO: 2. The GenBank
accession number for Bak is NP_001179.1, incorporated herein as SEQ
ID NO: 3. As is described below, a person of skill in the art can
design a variety of antisense nucleotides and siRNAs to disrupt
either transcription or translation of the target gene or mRNA,
respectively, to reduce expression of ASMase, Bax, or Bak.
Antisense nucleic acids for use in this invention therapeutically
to treat or prevent the enumerated diseases include cDNA, antisense
DNA, antisense RNA, and small interfering RNA, that are
sufficiently complementary to the target gene or mRNA encoding the
target protein to permit specific hybridization to the respective
gene or mRNA, thereby reducing expression of the target protein in
the animal compared to pretreatment levels.
In particular embodiments the enumerated diseases are treated or
prevented by administering a therapeutic amount of an antisense
nucleic acid from 8-50 nucleotides in length that specifically
hybridizes to SEQ ID NO. 2 which is the cDNA sequence for human
ASMase Accession No. NM 000543; or SEQ ID NO. 4 which is the CDNA
sequence for human Bax Accession No. NM 138761; or SEQ ID NO: 5
which is the cDNA sequence for human BAK Accession No. NM 001188.
In another embodiment the antisense is directed to various regions
of the respective genomic DNAs that would block transcription of
the respective gene, ASMase SEQ ID NO. 7, Bax SEQ ID NO: 8, or Bak
SEQ ID NO: 9. A patient could be treated with a combination of
these antisense nucleic acids in a single preparation or in
different preparationsadministered on the same or different days to
reduce expression of ASMase (protein sequence SEQ ID NO. 1), or Bax
(protein sequence SEQ ID NO.3); or Bak (protein sequence SEQ ID NO.
5). Alternatively, treatment could be achieved by administering the
appropriate siRNA to reduce expression of one or more of the
targeted proteins ASMase, Bax or Bak. More details regarding
antisense technology are set forth below.
For the purpose of this invention, a therapeutically effective
amount of a compound is an amount that achieves the desired
biologic or therapeutic effect, namely an amount that prevents,
reduces or ameliorates one or more symptoms of the enumerated
diseases being treated or prevented. A starting point for
determining an effective therapeutic amount of antisense or siRNA
is an amount that reduces expression of the targeted protein
ASMase, or Bax or Bak in a biological sample taken from a subject.
The therapeutic amount of imipramine can be similarly
determined.
Treatment and Prevention of IR-Induced Diseases and GI Syndrome
with Anti-Ceramide Antibodies
We conducted in vitro studies in Jurkat T cells showing that
sequestration of ceramide with anti-ceramide antibody inhibited
ceramide-mediated raft clustering, thereby attenuating apoptosis
and improving clonogenic survival (FIG. 4). To determine the in
vivo effects of anti-ceramide on radiation-induced apoptosis, 100
.mu.g the commercially sold mouse anti-ceramide antibody MID 15B4
or isotype control IgM was administered intravenously to C57BL/6
mice 30 min prior to 15 Gy TBI. Anti-ceramide infusion abrogated
endothelial apoptosis 4 hrs post 15 Gy, decreasing the incidence of
massive apoptosis (>10 apoptotic cells per villus) from 56.9% in
IgM treated controls to 13.7% (FIGS. 5B and D), pharmacologically
recapitulating the protection afforded by genetic inactivation of
ASMase (14.9%). These findings showed that anti-ceramide-mediated
protection of endothelium impacted GI stem cell lethality, and
thereby enhance overall animal survival. Antagonism of endothelial
apoptosis enhanced survival of crypt stem cell clonogens, evidenced
by increased incidence of surviving crypts 3.5 days following 15 Gy
irradiation. As anti-ceramide attenuated endothelial apoptosis,
pharmacologically recapitulating the asmase.sup.-/- phenotype, we
tested the impact on crypt survival. Pretreatment of C57BL/6 mice
with anti-ceramide prior to 15 Gy TBI resulted in a crypt surviving
fraction of 1.3.times.10-1, over 1 log of protection over the
9.3.times.10-3 surviving fraction exhibited by littermates treated
with irrelevant IgM prior to 15 Gy TBI (FIG. 5A). Irrelevant IgM
antibody did not impact crypt survival compared with untreated
C57BL/6 controls. Anti-ceramide antibody increased crypt survival
to similar levels as genetic inhibition of ASMase (1.2.times.10-1),
demonstrating that pharmacologic inhibition of ceramide signaling
mimics the protection afforded by genetic inactivation of ASMase on
crypt clonogen lethality in vivo. It should be noted that Bax and
Bak deficiencies did not impact the p53 mediated epithelial
apoptosis at crypt positions 4-5. Moreover, Bax and Bak do not
overlap functionally in the intestinal microvascular system.
Additional support can be found in J. A. Rotolo, et al, Int. J.
Radiation Oncology Biol. Phys., Vol. 70, No. 3, 804-815(2008),
incorporated herein by reference.
To assess whether anti-ceramide administration could recapitulate
the asmase.sup.-/- phenotype and increase animal survival following
15 Gy, C57BL/6 mice were pretreated with 50-100 .mu.g anti-ceramide
antibody or irrelevant IgM control and subjected to 15 Gy TBI.
Within 16 hrs of irradiation, mice were administered
3.times.10.sup.6 autologous bone marrow cells intravenously.
Consistent with previously published data, 15 Gy was 100% lethal in
C57BL/6 control of IgM treated mice by day 7. Anti-ceramide
antibody increased survival in a dose-dependent manner, with 100
.mu.g anti-ceramide pretreatment resulting in 60% survival 120 days
following irradiation (FIG. 5C). These findings correlate closely
to the survival of asmase.sup.-/- mice administered autologous BMT
following 15 Gy (F. Paris, Z. Fuks, A. Kang et al., Science 293
(5528), 293 (2001)). Autopsies revealed that mice receiving control
IgM died with extensive intestinal damage, including completely
denuded crypts and villi, with only partial damage to the bone
marrow (not shown). These findings are consistent with death from
the GI syndrome. Conversely, autopsies of mice that died following
anti-ceramide pretreatment revealed typical characteristics of bone
marrow death, including extensive hemorrhage and near complete
depletion of hematopoietic elements (not shown). These mice
exhibited intestinal mucosa in regenerative states, containing
hyperplastic, chromophilic crypts covering most of the intestinal
surface. FIG. 5D shows micrographs of small intestine obtained 4
hrs following 15 Gy-irradiation were stained by TUNEL. Apoptotic
cells are indicated by brown-stained nuclei. Data (mean.+-.SEM)
were obtained from minimum 150 villi from two independent
experiments. These data demonstrate that anti-ceramide antibody
effectively antagonizes ceramide signaling in vivo, recapitulating
the asmase.sup.-/- phenotype pharmacologically and protecting
against radiation-induced disease and GI syndrome
Based on this evidence for the role of extracellular ceramide in
apoptosis, certain embodiments of the invention are directed to
methods for treating or preventing radiation-induced disease and GI
syndrome by administering a therapeutic amount of one or more
anti-ceramide antibodies or a biologically active fragment thereof,
preferably humanized forms. These antibodies can be polyclonal or
monoclonal. In a preferred embodiment the anti-ceramide antibody is
monoclonal 2A2 antibody or a biologically active fragment thereof,
described below, preferably in humanized form. A new and effective
monoclonal anti-ceramide antibody we discovered called 2A2 IgM is
described in detail below. Previous work described above showed
that statins (nystatin) also had beneficial effects in reducing
apoptosis in in vitro models. Therefore certain other embodiments
include administering a therapeutic amount of an anti-ceramide
antibody or biologically active fragment thereof, and one or more
statins, administered alone or in combination to treat or prevent
GI syndrome. The therapeutic agents described herein for
combination therapy can be administered on the same or on
consecutive days.
Statins include any of a group of drugs that lower the amount of
cholesterol and certain fats in the blood. Statins inhibit a key
enzyme that helps make cholesterol. The statins are divided into
two groups: fermentation-derived and synthetic. The statins
include, in alphabetical order (brand names vary in different
countries):
TABLE-US-00002 Statin Brand name Derivation Atorvastatin Lipitor,
Torvast Synthetic Cerivastatin Lipobay, Baycol. (Withdrawn
Synthetic from the market in August, 2001 due to risk of serious
adverse effects) Fluvastatin Lescol, Lescol XL Synthetic Lovastatin
Mevacor, Altocor Fermentation-derived Mevastatin --
Naturally-occurring compound. Found in red yeast rice. Pitavastatin
Pravachol, Selektine, Lipostat Fermentation-derived Rosuvastatin
Crestor Synthetic Simvastatin Zocor, Lipex Fermentation-derived.
(Simvastatin is a synthetic derivate of a fermentation product)
Simvastatin + Ezetimibe Vytorin Combination therapy Lovastatin +
Niacin Advicor Combination therapy extended-release Atorvastatin +
Amlodipine Caduet Combination therapy Besylate Cholesterol + Blood
Pressure
LDL-lowering potency varies between agents. Cerivastatin is the
most potent, followed by (in order of decreasing potency)
rosuvastatin, atorvastatin, simvastatin, lovastatin, pravastatin,
2A2 Anti-Ceramide Monoclonal IgM Antibody
A flow chart of the strategy used to generate novel anti-ceramide
antibodies with potent in vivo activity is shown in FIG. 6. In
order to make the antibody, we first needed to develop an antigen
that was immunogenic enough to generate a strong antibody response
from an inoculated host. BSA-conjugated ceramide was generated by
synthesizing BSA-conjugated C.sub.16 fatty acid onto a sphingoid
base. FIG. 7) inset. Validation of the Antigen for antibody
screening was performed by ELISA assay, in which decreasing amounts
of Antigen were fixed to a plate. After blocking each well, the
plate was then incubated with anti-ceramide MID15B4 antibody
(1:100) commercially available from Axxora LLC, San Diego Calif.
followed by horseradish peroxidase-conjugated anti-mouse IgM. OD
was assessed following administration of HRP substrate at 650 nm.
The BSA-ceramide ELISA identified enhanced binding activity in
supernatant #3673 following immunization with Kaposi sarcoma cells.
FIG. 8. Binding of plasma samples obtained from immunized mice by
ELISA at 1:100 dilution identified higher binding of ceramide by
sample #3673 vs. #3674. Binding activity remained following
immortalization of antibody producing B cells (sn73-I-C6), enabling
the isolation of monoclonal 2A2 IgM with anti-ceramide binding
activity (not shown). Karposi immunization was intended to generate
a strong immune response which would result in generation of a
panel of antibody-producing B cells. The antibody-containing
supernatant from the hybridomas generated from these B cells was
then screened against the BSA-ceramide ELISA. Supernatants that
tested positive in the assay were isolated, eventually resulting in
purification of clone 2A2. More details are set forth in Example
4.
Purified monoclonal 2A2 antibody was isolated from supernatant
#3673. Elisa revealed that the 2A2 mouse monoclonal IgM bound to
BSA-ceramide. FIG. 9. Elisa showed significantly more binding
capacity of 2A2 vs. control IgM. We show that the 2A2 antibody
works in vivo and we were able to humanize it for clinical use.
Methods for humanizing the antibody and others are set forth in
Example 1.
Consistent with our earlier observations in vitro with commercial
antibodies, purified 2A2 antibody antagonized radiation-induced
apoptosis in vitro. Preincubation of Jurkat cells with 2A2
monoclonal anti-ceramide antibody (25-100 micrograms/mL) inhibited
8 Gy-induced apoptosis. FIG. 10; quantified as in FIG. 4B.
Calculation of apoptosis inhibition was performed relative to the
mean apoptosis of untreated Jurkat cells prior to 8 Gy. Other
anti-ceramide antibodies 1H4, 15D9 and 5H9, generated by
immunization of mice with C.sub.16 ceramide, can be humanized using
techniques known in the art, and come within the scope of this
invention for treatment or prevention of GI syndrome, and also
GvHD, autoimmune diseases and inflammation which are discussed
below.
In the next series of experiments we showed that 2A2 enhanced crypt
survival following 15 Gy in vivo. Pretreatment of C57BL/6 mice with
increasing doses of 2A2 anti-ceramide (0-750 micrograms) improved
crypt survival at the critical 3.5 day time point following 15 Gy
TBI. FIG. 11(A). 2A2 anti-ceramide antibody increased crypt
survival following 8-15 Gy total body irradiation by a
dose-modifying factor (DMF) of 1.2. FIG. 11(B). Crypt survival was
determined as in FIG. 5C. In our animal experiments we used 750
micrograms of antibody per 35 gram mouse. The location of ceramide
on the surface of activated T cells is particularly important for
treating or preventing any of the enumerated diseases using
antibody therapy because this target protein is accessible to the
antibodies.
In other experiments we discovered that anti 2A2 antibody also
improved survival of C57BL/6 mice exposed to 14-17 Gy single-dose
radiation. FIG. 12. C57BL/6 mice were irradiated with 14-17 Gy TBI
with or without 750 micrograms 2A2 15 min prior to IR. Mice were
infused with 3.times.10.sup.6 autologous bone marrow cells within
16 hour of IR. Survival was monitored and expressed via
Kaplan-Meier parameters. Statistical significance (P<0.05) was
achieved at each dose.
Over a range of exposures, we found that 2A2 antibody attenuated
radiation-induced GI death in vivo, recapitulating the
asmase.sup.-/- phenotype. Necropsy results of mice sacrificed when
moribund from survival studies performed in FIG. 13. GI death was
assessed when proximal jejunum specimen appear >90% denuded of
crypt-villi units and crypt regeneration is absent. Bone marrow
(BM) death was assessed when decalcified femur sections reveal
depletion of hematopoietic elements and massive hemorrhage.
These results support embodiments of the present invention directed
to the 2A2 antibody itself, or fragment or variant thereof,
preferably in humanized form. In another preferred embodiment the
human 2A2 antibody, or fragment thereof is administered in a
therapeutically effective amount to treat or prevent radiation
damage or GI syndrome. Where antibody is used herein, it is also
meant to include antibody fragments or variants as described below.
Certain other embodiments are directed to a composition comprising
an anti-ceramide antibody, preferably humanized, more preferably
2A2, and a statin in an amount that decreases circulating
cholesterol levels thereby increasing the efficacy of the
anti-ceramide antibody. Another embodiment is directed to treating
or preventing radiation damage or GI syndrome by administering
imipramine, and ASMase inhibitor presently used as an antipsychotic
agent, either alone or in combination with anti-ceramide antibodies
and/or statins. Another embodiment is a composition that includes
the 2A2 antibody and imipramine or antisense or siRNA that targets
ASMase or Bak.
Routine experimentation will determine the therapeutically
effective amount of humanized monoclonal anti-ceramide antibody to
use. The amount of anti-ceramide antibody to be administered
therapeutically ranges from about 1 ug to 100 ug/ml. This amount
typically varies and can be an amount sufficient to achieve serum
therapeutic agent levels typically of between about 1 microgram per
milliliter and about 10 micrograms per milliliter in the subject.
In the context of the present invention, anti-ceramide antibodies
are a type of neutralizing antibody that prevents ceramide from
blocking apoptosis.
As will be described below, we also discovered that 2A2 antibody
improved survival after BMT by reducing GvHD and reduced the
typical cytokine storm seen with GvHD.
We discovered other monoclonal antibodies made in mice that were
immunized with BSA-ceramide that when screened in a Jurkat cell
apoptosis inhibition assay and showed protective effects that were
dose dependent and comparable to 2A2. The isotypes of the three
antibodies have been established. 15D9 mAb is IgM, kappa. 1H4 and
5H9 mAbs are mIgG3, kappa. FIG. 25.
Certain embodiments of the invention are directed to these
monoclonal antibodies 15D9, 1H4 and 5H9, and to fragments or
variants thereof, preferably humanized for therapeutic use to treat
radiation induced diseases or GI syndrome, and as will be shown
below also GvHD, other autoimmune diseases and inflammation. Other
embodiments are directed to pharmaceutical compositions that
include these monoclonal antibodies, fragments or variants,
preferably in humanized form, and optional also imipramine or
statins or both.
One of the discoveries we made is that immunizing the host mice
with Karposi Sarcoma cells as described in Example 4, generated
effective anti-ceramide monoclonal antibodies with dramatic
therapeutic effects as shown for example with the 2A2 antibody. We
chose KS cells because for immunization because they recapitulate
activated endothelium which we have shown is ceramide-rich. Because
we immunized with activated cells and not just with a pure ceramide
antigen, the monoclonals we generated may cross react with other
proteins besides ceramide. By cross react in this application is
meant that the monoclonals may react with other proteins or protein
complexes besides ceramide. For example the epitope on ceramide
that these monoclonals react with (i.e. have affinity for) may be
shared with other cell surface proteins. Alternatively other
proteins may have a similar conformation at the antigenic site or
the epitope may be part of a complex that displays the ceramide.
Therefore certain other embodiments of the invention are directed
broadly to monoclonal antibodies that cross-react with ceramide,
wherein the antibodies are obtained by immunizing the host with
whole cells. Humanized monoclonals including fragments are a
preferred embodiment. The immunoglobulin subtype can be any
subtype, IgG, IgM are preferred but also IgA, IgE etc. may be
effective.
Treatment and Prevention of Graft-Vs.-Host Disease and Autoimmune
Disorders
The results presented below show for the first time that
ASMase-generated ceramide is required for GVHD, therefore certain
embodiments are directed to pharmacological methods to treat or
prevent GVHD by blocking ASMase (for example with imipramine or
with antisense nucleic acids) or inactivate this cell surface
ceramide (for example with anti-ceramide antibodies).
Autoimmune disorders are sustained adaptive immune responses
directed against self antigens. T cells recognize self antigens as
foreign due to incompatibilities between T cell and tissue major
histocompatibility complex (MHC) molecules and/or minor
histocompatibilty antigens (mHAGs), cell surface molecules
expressed on most cell types. Activated T cells directed against
self antigens inflict tissue damage and chronic inflammation
directly (via cytotoxic T cells, CTLs) or indirectly (via antibody
generation by T cell help to self-reactive B cells). Acute
graft-versus-host disease (GvHD), the primary complication of
hematopoietic stem cell transplantation, is a unique
autoimmune-like disorder arising from the differentiation and
activation of alloreactive donor T cells infused into an
immunoablated host. In acute GvHD, recognition of alloantigens
(major or minor mismatched) of the host by donor T cells initiates
an adaptive immune response including incipient damage to host
tissue and Type I cytokine (IFN-.gamma. and IL-2) generation. This
results in CTL clonal expansion and activation, that along with a
developing macrophage-dependent "cytokine storm" comprised of
inflammatory cytokines (TNF-.alpha. and IL-1.beta.) (D. A. Wall and
K. C. Sheehan, Transplantation 57 (2), 273 (1994); G. R. Hill, W.
Krenger, and J. L. Ferrara, Cytokines Cell Mol Ther 3 (4), 257
(1997); J. L. Ferrara, Bone Marrow Transplant 21 Suppl 3, S13
(1998), induces apoptosis in a select set of target cells (A. C.
Gilliam, D. Whitaker-Menezes, R. Korngold et al., J Invest Dermatol
107 (3), 377 (1996)), and consequent damage to associated target
organs (liver, intestines and skin) D. A. Wall, supra; G. F.
Murphy, D. Whitaker, J. Sprent et al., Am J Pathol 138 (4), 983
(1991)). Common symptoms of acute GvHD include severe weight loss,
diarrhea, liver disease, rash and jaundice. FIG. 14 is a cartoon
illustrating the immunopathology of GvHD.
High dose chemotherapy and radiation used in the treatment of many
types of leukemia and lymphomas additionally kill rapidly dividing
bone marrow cells stem cells, resulting in immunoablation and
necessitating reconstitution of haematopoietic elements. Bone
marrow transplantation (BMT) is a common and effective therapy for
immune reconstitution in these patients, as well as treatment for
immune disorders including aplastic anemia and severe combined
immunodeficiency, in which infusion of bone marrow stem cells can
correct deficiencies in red blood, T and/or B cells. GvHD is the
major complication associated with BMT, occurring in 30% of MHC
matched, 50% of single MHC disparate and 70% of double MHC
disparate BMTs from related donors, and even higher when a
non-related donor is used.sup.86. Despite extensive research, there
is no good treatment. Acute GvHD typically develops within 3 months
of BMT, during which specific organs including the gut, skin and
liver are targeted by cytotoxic T cells. Until now, the clinically
relevant strategies available to control GvHD are limited to T cell
depletion from the allograft or non-specific immunosuppression
aimed to control donor T cell expansion and activation, approaches
that increase the likelihood of infection or neoplastic relapse in
already immunocompromised patients.
Pharmacologic and genetic tools have enabled identification of
several key mediators of CTL-induced apoptotic cell death at the
cellular level. Liver, intestinal and skin apoptosis during acute
GvHD is primarily mediated via CTL attack of host tissue via
Fas-Fas ligand (FasL) (H. Kuwahara, Y. Tani, Y. Ogawa et al., Clin
Immunol 99 (3), 340 (2001); C. Schmaltz, O. Alpdogan, K. J.
Horndasch et al., Blood 97 (9), 2886 (2001); K. Hattori, T. Hirano,
H. Miyajima et al., Blood 91 (11), 4051 (1998)) and TNF-TNFR
pathways, with minimal contribution from perforin/granzyme-mediated
cell lysis. Inhibition of TNF-superfamily receptor signaling
largely attenuated acute GvHD-associated mortality in major and
minor mismatched models of murine allogeneic BMT, either by genetic
inactivation of donor T cell Fas ligand or TNF-.alpha., or
antibody-mediated neutralization of their cognate receptors
CD95/Fas and TNFR, respectively. These studies established an
essential role for death receptor signaling in donor CTL function
in the pathogenesis of acute GvHD, and suggested that promiscuous
inhibition of TNF-superfamily signaling might provide potent
protection from GvH-associated pathology.
A number of recent studies identify a role for the sphingomyelin
pathway and its second messenger ceramide in autoimmune, liver and
GI toxicities. Genetic inactivation of ASMase abrogates autoimmune
mouse models of phytohemagglutin (PHA)-induced Fas-dependent
autoimmune hepatitis, during which induction of FasL on lymphocytes
results in selective killing of hepatocytes expressing Fas, and
activation of the HIV receptor gp120 by anti-CD4 antibody, in which
depletion of CD4.sup.+ T cells occurs due to upregulation of Fas
and FasL on these cells. Further, evidence indicates that ceramide
generation on the exoplasmic leaflet of the cell membrane occurs
rapidly in the course of ischemia-reperfusion injury L. Llacuna, M.
Mari, C. Garcia-Ruiz et al., Hepatology 44 (3), 561 (2006)), and
TNF-induced hepatocyte apoptosis that leads to cirrhosis.sup.93 and
radiation-induced GI toxicity that has already been discussed using
standardized animal models for these disease entities.
Acute GvHD, the primary complication of hematopoietic stem cell
transplantation, is a well-defined autoimmune-like disorder
mediated by donor cytolytic T cell attack on host tissue. To
evaluate the contribution of target cell ASMase and ceramide in
CTL-mediated tissue injury and mortality during acute GvHD, a minor
histocompatability-incompatible allogeneic BM transplantation model
of LP/J donor (H-2.sup.b) into C57BL/6 recipient (H-2.sup.b) was
selected. Lethally-irradiated C57BL/6 hosts of asmase.sup.+/+ or
asmase.sup.-/- background received 5.times.10.sup.6 T-cell depleted
(TCD) LP/J BM cells, and GvHD was induced by the addition of
3.times.10.sup.6 LP/J donor splenic T cells to the allograft.
Transplantation of donor LP/J BM and T cells induced the
development of GvHD in all recipients, albeit with reduced effect
in asmase.sup.-/- recipients as determined by Kaplan-Meier survival
(FIG. 15A) and clinical GvHD score (FIG. 15B) curves. GvHD survival
was increased from 28.6% in asmase.sup.+/+ recipients of BM and T
cells to 84.6% in asmase.sup.-/- recipients (p<0.005), and was
accompanied by consistently lower clinical scoring through day 90
in the asmase.sup.-/- recipients (FIG. 15B and not shown),
indicative of attenuated GvHD in asmase.sup.-/- recipients. These
results identify a role for ASMase in acute GvHD-induced mortality
in a minor MHC-disparate allogeneic BMT model.
GvH-induced mortality is associated with injury to select organs
including the ileum, liver and skin. Example 2 describes
experiments showing that ASMase is required for GvHD target organ
injury and apoptosis. Experiments in Example 2 show that ASMase
deficiency largely protected GvHD-associated organ damage,
decreasing scoring to 10.2.+-.0.5 and 7.+-.0.1 in liver and small
intestines, respectively (Table 1, p<0.005 each for liver and
intestine vs. asmase.sup.+/+ littermates). ASMase deficiency also
protected hosts from cutaneous keratinocyte apoptosis following
minor antigen-mismatched allogeneic BMT. Further GvHD-associated
organ injury was shown to be associated with prominent intestine
and skin apoptosis. These data identify a significant attenuation
of GvHD-associated target organ damage and apoptosis, closely
correlating with protection against GvHD morbidity and mortality,
in asmase.sup.-/- hosts compared to wild type littermates across
both minor and major antigen disparities.
Additional experiments described in Example 3 show that ASMase
deficiency attenuated the cytokine storm associated with GvHD and
inflammation generally, thus protecting the host from inflammation.
The experiments showed that ASMase inactivation attenuated Th1/Th2
cytokine profile and CD8.sup.+ T cell proliferation in acute GvHD
in recipients of allogeneic BM and T cells. Our data showed
deficient in vivo CD8.sup.+ CTL proliferation in asmase.sup.-/-
hosts, and biologically-relevant consequences to the attenuation of
serum proinflammatory cytokine levels in these BMT recipients
having GvHD. Thus, the in vivo data confirm a role for ASMase in
GvH-associated morbidity, mortality and target organ damage. The
impact of host ASMase deficiency affects GvHD pathophysiology
primarily by to altering systemic factors (i.e. cytokines, number
of circulating T cells) and not by inactivation of T cell
killing.
Administration of Anti-Ceramide Antibody Prevents GvHD
To assess whether ceramide-mediated raft clustering into membrane
platforms is an essential component of cytolytic T cell
(CTL)-induced apoptosis of hepatocytes, we blocked raft clustering
pharmacologically and examined the impact on alloactivated
CTL-induced hepatocyte apoptosis in vitro. To investigate whether
ASMase deficiency renders target cells directly resistant to
CTL-induced apoptosis, GvHD-mediated target cell lysis was
deconstructed in a 2-cell ex vivo model using alloactivated splenic
CTL effectors freshly-isolated from mice exhibiting active GvHD and
naive C57BL/6 hepatocytes. Hepatocytes were chosen as target cells
in this assay because they are a critical target for GvHD and
utilize the sphingomyelin pathway for apoptosis. Under the
conditions of our assay, 0.5.times.10.sup.6 hepatocytes were
co-incubated with 0-2.times.10.sup.6 alloactive splenic T cells
isolated from LP/J BM+T cells.fwdarw.B6 recipients. Co-incubation
induced increased hepatocyte apoptosis from a baseline of
4.7.+-.0.7% to 33.8.+-.1.9% by 16 hr, as detected by nuclear
morphologic changes (FIG. 16A). Consistent with data from a number
of in vivo studies, B6.MRL.lpr hepatocytes lacking a functional Fas
receptor were resistant to this mode of CTL-induced apoptosis (FIG.
16A, left panel), while selective inhibition of the granule
exocytosis-mediated cytolytic pathway by 2 hr incubation with 100
ng/ml CMA had no effect on hepatocyte apoptosis (FIG. 16A, right
panel). These studies indicate that CTL-mediated hepatocyte
apoptosis in this model requires Fas but not perforin/granzyme
signaling. Although prior studies showed that Fas levels were
unaltered in asmase.sup.-/- hepatocytes, asmase.sup.-/- hepatocytes
were nonetheless resistant to apoptosis in the ex vivo GvHD model
at all doses of allogeneic effector T cells from
0.1-2.times.10.sup.6 (FIG. 16B), and at all times from 4-48 hr
(data not shown).
Whereas Fas-mediated apoptotic death receptor activation requires
generation of ceramide-rich platforms in some cell systems,
CTL-induced platform generation was assessed in asmase.sup.+/+ and
asmase.sup.-/- hepatocytes in the ex vivo model of GvHD.
Alloactivated T cells induced rapid generation of ceramide-rich
platforms on the surface of the target hepatocytes 10 min following
co-incubation (FIG. 16C). Platform generation increased within one
minute, peaked at 10 min, and persisted for over 60 min (FIG. 16D).
Fas, required for apoptosis in this system, concentrated within the
ceramide-rich platform as determined by confocal microscopy. In
contrast, asmase.sup.-/- hepatocytes were completely resistant to
ceramide-rich platform formation (FIG. 16C and quantified in FIG.
16D) and Fas concentration therein, demonstrating that CTL-induced
platform generation in hepatocytes was ASMase-dependent.
Concomitantly, CTLs induced a 1.5.+-.0.1 fold overall increase in
ceramide signal as determined by mean fluorescence intensity per
pixel in asmase.sup.+/+ hepatocytes (p<0.005 compared to
unstimulated controls) which did not occur in asmase.sup.-/-
hepatocytes, accounting for the difference in intensity of the
ceramide staining in the upper vs. lower panels of FIG. 16C.
To demonstrate that hepatocyte apoptosis was specifically
ceramide-dependent and not a consequence of ASMase deficiency, we
added sub-apoptotic concentrations of exogenous C16-ceramide (up to
500 nM) to asmase.sup.-/- hepatocytes in the ex vivo GvHD assay.
Consistent with restoration of platform generation in human
asmase.sup.-/- lymphocytes by low dose long chain natural ceramide,
a sublethal dose of exogenous C.sub.16-ceramide (.gtoreq.200 nM)
restored platform formation in CTL-treated asmase.sup.-/-
hepatocytes to 46.3.+-.1.3% of cells, demonstrating that
ASMase-mediated ceramide generation drives platform formation.
C.sub.16-ceramide nearly completely restored CTL-induced apoptosis
to asmase.sup.-/- hepatocytes (FIG. 16E), bypassing the requirement
for target cell ASMase. In contrast, C.sub.16-dihydroceramide, the
biologically-inactive analog of C.sub.16-ceramide, failed to
restore CTL-induced platform generation (not shown) or hepatocyte
apoptosis (FIG. 16E). These data demonstrate unequivocally that
CTL-induced hepatocyte apoptosis ex vivo requires target cell
ceramide generation for efficient cell death induction, consistent
with in vivo protection from acute GvHD observed in asmase.sup.-/-
mice. Furthermore, pharmacologic disruption of cell surface rafts,
sites of sphingomyelin concentration, with the
cholesterol-chelating agent nystatin abrogated CTL-induced
ceramide-rich platform generation (not shown) and completely
inhibited 2.times.10.sup.6 alloactivated CTL-induced hepatocyte
apoptosis (FIG. 16F). Exogenous C.sub.16-ceramide was unable to
overcome cholesterol chelation (FIG. 16F), suggesting that
ceramide-rich platform formation requires functional rafts for
signaling, possibly serving as a site for pre-assembly of the
apoptotic machinery.
To show the generic role of target cell ASMase in T cell-induced
lysis, we used two standardized assays for T cell function;
MLR-primed CTL-induced splenocyte lysis (FIG. 17) and in vitro
activation-induced cell death (AICD) of T cells (FIG. 18). The role
of target cell ASMase was assessed in an in vitro activated MLR, in
which C57BL/6 splenocyte target cells of asmase.sup.+/+ or
asmase.sup.-/- genotype were stimulated for 48 hrs with mitogen,
washed and chromium labeled. These cells were then coincubated with
effector Balb/c splenocytes activated for 5 days by culture with
irradiated C57BL/6 splenocytes. Chromium release was quantified and
the % lysis was calculated. To test the ability of in vitro
activated splenocytes to lyse asmase.sup.-/- target cells, Balb/c
effector T cells were activated by culture for 5 days with
5.times.10.sup.6 irradiated (2 Gy) C57BL/6 splenocytes. Target
asmase.sup.+/+ or asmase.sup.-/- C57BL/6 splenocytes were prepared
by stimulation with 10 mg/ml conA for 48 hrs and .sup.51Cr labeled
to assess CTL-mediated chromium release. Washed splenocytes cells
were coincubated with increasing ratios of activated effector
Balb/c T cells, and .sup.51Cr release was quantified 6 hour
thereafter. FIG. 19A.
To evaluate a potential generic role for target cell ASMase in
platform generation in T cell-induced lysis, we tested two
standardized assays for T cell-mediated cytolysis, MLR-primed
CTL-induced splenocyte lysis, and in vitro AICD of T cells. For the
in vitro activated splenocyte lysis assay, BALB/c effector T cells
were stimulated by culture for 5 days with 5.times.10.sup.6
irradiated (2 Gy) C57BL/6 splenocytes, and thereafter coincubated
with asmase.sup.+/+ or asmase.sup.-/- target C57BL/6 splenocytes
prepared by stimulation with 10 g/ml conA for 48 hr. Co-incubation
of effector T cells with asmase.sup.+/+ target splenocytes,
Mitotracker Red-labeled for detection, resulted in rapid generation
on target cells of ceramide-rich platforms. Within 5 min of
co-incubation, platform incidence on target asmase.sup.+/+
splenocytes increased from 4.7.+-.2.1 to 25.8.+-.6.6% (p<0.01;
FIG. 19A). Fas colocalized within these ceramide-rich platforms
(data not shown). Platform generation was absent in asmase.sup.-/-
splenocytes, apparent in only 5.9.+-.3.5% of the population 10 min
post stimulation. Furthermore, MLR-primed CTLs induced 43.2.+-.6.5%
asmase.sup.+/+ splenocyte lysis at an effector:target ratio of 50:1
(FIG. 19B), attenuated to 7.3.+-.2.5% lysis in asmase.sup.-/-
target cells, as quantified by .sup.51Cr-release assay. Sublethal
exogenous 500 nM C.sub.16-ceramide restored both platform
generation and CTL-induced lysis of asmase.sup.-/- target
splenocytes, whereas C.sub.16-dihydroceramide was ineffective in
both events (not shown and FIG. 19C). These data indicate that in
vitro-primed CTL lysis of conA blasts activates target cell
platform generation in an ASMase-dependent manner, and that
platforms are required for efficient lysis of target cells in these
models.
To define a role for target cell ASMase in AICD, asmase.sup.+/+,
asmase.sup.-/- or MRL.lpr (FasR.sup.-/-) T cells were stimulated
for 24 hr with 10 microgam/ml ConA, washed, rested in medium
containing 20 U/ml rIL-2 for 24 hr, and finally AICD was initiated
by restimulation in medium containing 20 U/ml rIL-2 and increasing
concentrations of plate bound anti-CD3 mAb for 24 hr. AICD
induction by anti-CD3 mAb conferred ceramide-rich platform
generation 4 hr following stimulation (FIG. 19D), evident in
26.4.+-.1.6% of the population of asmase.sup.+/+ T cells compared
to 5.1.+-.1.0% of asmase.sup.-/- T cells (p<0.005). Confocal
analysis identified colocalization of the sphingolipid GM.sub.1
(FIG. 19E) and Fas within ceramide-rich platforms in asmase.sup.+/+
T cells.
To characterize the impact of platform generation on AICD,
asmase.sup.+/+ and asmase.sup.-/- T cells were induced to undergo
AICD and apoptosis was quantified 16 hr thereafter. Apoptosis in
asmase.sup.+/+ T cells was anti-CD3 mAb dose-dependent, reaching
32.9.+-.5.2% apoptosis 16 hr post induction (FIG. 19F). In
contrast, apoptosis was abrogated in MRL.lpr (FasR.sup.-/-) T cells
(FIG. 19F), confirming the requirement for Fas/FasL interaction in
this system. While asmase.sup.-/- i T cells were induced to
proliferate by anti-CD3 mAb equally well as asmase.sup.+/+ T cells,
and were equally effective as asmase.sup.+/+ T cells in lysis of
tumor cells, they displayed near complete resistance to
AICD-induced apoptosis in vitro. asmase.sup.-/- splenocytes failed
to undergo detectable apoptosis above background (8.8%) in response
to up to 10 ng/ml anti-CD3 (p<0.05 vs. asmase.sup.+/+ at 10
ng/ml anti-CD3; FIG. 19F). This occurred despite normal
upregulation of Fas and FasL (not shown). Natural long chain
C.sub.16-ceramide, but not C.sub.16-dihydoceramide, completely
restored platform generation in (not shown) and apoptosis of
asmase.sup.-/- T cells stimulated to undergo AICD (FIG. 19G). These
data provide compelling evidence that target cell ASMase-mediated
ceramide-rich platform formation is required for T cell-induced
apoptosis in both antigen-disparate and fratricidic settings.
Treatment and Prevention of GvHD with Anti-Ceramide Antibody
We next looked at the effect of treatment with 2A2 anti-ceramide
antibody IgM on survival following allogeneic bone marrow and T
cell transplantation (FIG. 20). Using the same of LP/J donor (H-2b)
into C57BL/6 recipient (H-2b) model described in FIG. 15, we
demonstrate that 2A2 antibody treatment significantly reduced
objective indicia of acute graft-versus-host disease in vivo,
partially recapitulating the asmase-/- phenotype. C57BL/6asmase+/+
or C57BL/6asmase-/- were lethally irradiated with a split dose of
1100 cGy TBI. The C57BL/6asmase+/+ group receiving 2A2 antibody
received 750 micrograms antibody 15 min prior to the first half of
split-dose TBI. Thereafter, all mice received intravenous injection
of minor antigen-mismatched LP TCD-BM cells (5.times.106) with
splenic T cells (3.times.106). Survival was monitored daily, and
results were expressed by Kaplan-Meier survival analysis.
Administration of 2A2 increased animal survival 100 days following
transplantation from 12.5% to 60% (FIG. 20).
Given the role that ASMase plays in GvHD cytokine storm generation,
we next studied the ability of 2A2 Antibody to attenuate this
adverse response. Serum was harvested from wild type,
asmase.sup.-/- and 2A2-treated animals on day 7 following BMT from
the group analyzed as described above (FIG. 21). Serum
interferon-gamma was quantified by ELISA, according to
manufacturer's protocol (R&D Systems). Our results show that WT
mice treated with 2A2 mAb responded similarly to ASMase deficient
mice, with an approximate 25% reduction in serum interferon
gamma.
These results show that GvHD and other T cell-mediated autoimmune
diseases associated with an increase in pro-inflammatory cytokines
can be treated by administering a therapeutic amount of an
anti-ceramide antibody, preferably 2A2 anti-ceramide monoclonal IgM
or a biologically active fragment thereof as is described herein.
Our in vitro results showed that nystatin also decreased T cell
cytolysis ex vivo support certain embodiments wherein GvHD and
autoimmune diseases are treated or prevented by administering one
or more statins, preferably together with a humanized anti-ceramide
antibody such as 2A2. Other embodiments are directed to new
compositions of one or more statins and one or more anti-ceramide
antibodies. As for treating GI syndrome, routine experimentation
will determine the effective amount of humanized monoclonal
anti-ceramide antibody to use. The amount of anti-ceramide antibody
to be administered therapeutically ranges from about 1 ug to 100
ug/ml. This amount typically varies and can be an amount sufficient
to achieve serum therapeutic agent levels typically of between
about 1 microgram per milliliter and about 10 micrograms per
milliliter in the subject.
The present studies define formation of ceramide-rich membrane
platforms in the exoplasmic leaflet of the plasma membrane of
target cells as a critical step in both microvascular apoptosis of
the GI following ionizing radiation and lytic attack by CTLs upon
immune targets. These structures, which form within seconds of
stimulation, are readily detected by confocal or conventional
microscopy as they are quite large, often reaching three microns in
diameter. We have shown that genetic or pharmacologic disruption of
platforms, for example by blocking ASMase or Bax and by
administering anti-ceramide antibodies, prevents radiation-induced
cell death in vitro and in vivo, as well as CTL-mediated death in
three distinct cellular models of CTL-induced cell killing.
Treatment with monoclonal anti-ceramide antibodies markedly reduced
multiple aspects of the pathophysiologic response in
gastrointestinal radiation toxicity and standardized major and
minor mismatch models of GvHD.
Summary
The present studies provide new evidence that linkage between
microvascular endothelial apoptosis and stem cell clonogen
lethality is a generic mechanism for induction of radiation damage
to the mouse intestines. Bax deficient mice provide evidence that
it is the endothelial apoptotic response, rather than another event
regulated by ASMase signaling, that impacts the fate of irradiated
crypt stem cell clonogens. The availability of a pharmacologic that
can inhibit ASMase (such as imipramine, antisense nucleic acids or
siRNA) is a valuable therapeutic in patients requiring high dose
abdominal radiation, with the potential of selectively antagonizing
GI toxicity without impacting tumor cell kill. Another valuable
therapy is the use of ceramide-targeting pharmacologics such as
anti-ceramide antibody to antagonize raft clustering and apoptosis
of the GI early in the response to accidental radiation exposure or
large-scale radiological incident. Lethal GI toxicity following
radiation exposure, for which there is no current therapeutic
option, is a primary concern of the National Institute of Health in
lieu of the current state of world affairs.
As the results we presented here show, ceramide-rich platforms are
required for T cell-mediated autoimmune syndromes in vivo. ASMase
had been shown to regulate hepatocyte apoptosis in phytohemagglutin
(PHA)-induced hepatitis, a model for acute T-cell mediated
autoaggressive liver disorder (S. Kirschnek, F. Paris, M. Weller et
al., J Biol Chem 275 (35), 27316 (2000)). PHA stimulates FasL
induction on lymphocytes and upon their migration to the liver,
hepatocytes are killed by apoptosis, prompting hepatitis (K. Seino,
N. Kayagaki, K. Takeda et al., Gastroenterology 113 (4), 1315
(1997)). ASMase deficiency protected hepatocytes from apoptosis
despite normal upregulation of lymphocyte FasL. A role for ASMase
in CD4-activated T cell-induced cytolysis has been reported (Z. Q.
Wang, A. Dudhane, T. Orlikowsky et al., Eur J Immunol 24 (7), 1549
(1994)). CD4 activation by the HIV receptor molecule gp120, or by
an agonistic anti-CD4 antibody, activates the Fas/FasL system and
initiates apoptosis, whereas CD4.sup.+ T cells deficient in ASMase
were unable to undergo apoptosis upon in vivo injection of anti-CD4
antibody (S. Kirschnek, F. Paris, M. Weller et al., J Biol Chem 275
(35), 27316 (2000)). We have now shown that ASMase-generated
ceramide is universally required in cytokine-mediated T
cell-induced apoptosis, and in preventing apoptosis of endothelial
microvasculature which underlies the pathology of GI syndrome). We
have shown that blocking ASMase-generated ceramide with
anti-ceramide antibodies also decreased serum proinflammatory
cytokine expression. Thus any disease working through TNF
superfamily receptor signaling including Fas/FasL and TNF/TNFR
interactions can be treated or prevented by administering a
therapeutic amount of an antibody that binds to the
ASMase-generated ceramide or by inhibition of ASMase or Bax.
The experiments described herein show for the first time that
activation of host ASMase and formation of ceramide-rich platforms
are critical events in instigation of acute GvHD. We showed this by
the marked reduction in Type I cytokine production and CTL clonal
expansion, steps necessary to feed forward GvHD, when mismatched
alloactivated CTLs are added to marrow transplants into
asmase.sup.-/- mice. As with GI syndrome, although different
etiologies, GvHD responded to treatment with anti-ceramide
antibodies and blocking ASMase or Bax expression.
The benefit of inactivation of ceramide-rich platforms is not
restricted to Fas-mediated biologic effects because other
inflammatory cytokines including but not limited to TNF, IL-1 and
TRAIL similarly use ASMase for transmembrane signal transmission.
Hence, ASMase-generated ceramide-rich platforms represent a
promiscuous target for GvHD and other immune disorders that utilize
multiple cytokines to instigate pathophysiology.
Antibodies
An "antibody" refers to an intact immunoglobulin or to an
antigen-binding portion thereof that competes with the intact
antibody for specific binding. Antigen-binding portions may be
produced by recombinant DNA techniques or by enzymatic or chemical
cleavage of intact antibodies. Antigen-binding portions include,
inter alia, Fab, Fab', F(ab').sub.2, Fv, dAb, and complementarity
determining region (CDR) fragments, single-chain antibodies (scFv),
chimeric antibodies, diabodies and polypeptides that contain at
least a portion of an immunoglobulin that is sufficient to confer
specific antigen binding to the polypeptide.
An "immunoglobulin" is a tetrameric molecule. In a
naturally-occurring immunoglobulin, each tetramer is composed of
two identical pairs of polypeptide chains, each pair having one
"light" (about 25 kDa) and one "heavy" chain (about 50-70 kDa). The
amino-terminal portion of each chain includes a variable region of
about 100 to 110 or more amino acids primarily responsible for
antigen recognition. The carboxy-terminal portion of each chain
defines a constant region primarily responsible for effector
function. Human light chains are classified as .kappa. and .lamda.
light chains. Heavy chains are classified as .mu., .DELTA.,
.gamma., .alpha., or .epsilon., and define the antibody's isotype
as IgM, IgD, IgG, IgA, and IgE, respectively. Within light and
heavy chains, the variable and constant regions are joined by a "J"
region of about 12 or more amino acids, with the heavy chain also
including a "D" region of about 10 more amino acids. See generally,
Fundamental Immunology Ch. 7 (Paul, W., ed., 2nd ed. Raven Press,
N.Y. (1989)) (incorporated by reference in its entirety for all
purposes). The variable regions of each light/heavy chain pair form
the antibody binding site such that an intact immunoglobulin has
two binding sites. Immunoglobulin chains exhibit the same general
structure of relatively conserved framework regions (FR) joined by
three hypervariable regions, also called complementarity
determining regions or CDRs. The CDRs from the two chains of each
pair are aligned by the framework regions, enabling binding to a
specific epitope. From N-terminus to C-terminus, both light and
heavy chains comprise the domains FR1, CDR1, FR2, CDR2, FR3, CDR3
and FR4. The assignment of amino acids to each domain is in
accordance with the definitions of Kabat Sequences of Proteins of
Immunological Interest (National Institutes of Health, Bethesda,
Md. (1987 and 1991)), or Chothia & Lesk J. Mol. Biol. 196:901
917 (1987); Chothia et al. Nature 342:878 883 (1989).
An Fab fragment is a monovalent fragment consisting of the VL, VH,
CL and CH I domains; a F(ab').sub.2 fragment is a bivalent fragment
comprising two Fab fragments linked by a disulfide bridge at the
hinge region; a Fd fragment consists of the VH and CH1 domains; an
Fv fragment consists of the VL and VH domains of a single arm of an
antibody; and a dAb fragment (Ward et al., Nature 341:544 546,
1989) consists of a VH domain. A single-chain antibody (scFv) is an
antibody in which a VL and VH regions are paired to form a
monovalent molecules via a synthetic linker that enables them to be
made as a single protein chain (Bird et al., Science 242:423 426,
1988 and Huston et al., Proc. Natl. Acad. Sci. USA 85:5879 5883,
1988). Diabodies are bivalent, bispecific antibodies in which VH
and VL domains are expressed on a single polypeptide chain, but
using a linker that is too short to allow for pairing between the
two domains on the same chain, thereby forcing the domains to pair
with complementary domains of another chain and creating two
antigen binding sites (see e.g., Holliger, P., et al., Proc. Natl.
Acad. Sci. USA 90:6444 6448, 1993, and Poljak, R. J., et al.,
Structure 2:1121 1123, 1994). One or more CDRs may be incorporated
into a molecule either covalently or noncovalently to make it an
immunoadhesin. An immunoadhesin may incorporate the CDR(s) as part
of a larger polypeptide chain, may covalently link the CDR(s) to
another polypeptide chain, or may incorporate the CDR(s)
noncovalently. The CDRs permit the immunoadhesin to specifically
bind to a particular antigen of interest.
An antibody may have one or more binding sites. If there is more
than one binding site, the binding sites may be identical to one
another or may be different. For instance, a naturally-occurring
immunoglobulin has two identical binding sites, a single-chain
antibody or Fab fragment has one binding site, while a "bispecific"
or "bifunctional" antibody has two different binding sites.
An "isolated antibody" is an antibody that (1) is not associated
with naturally-associated components, including other
naturally-associated antibodies, that accompany it in its native
state, (2) is free of other proteins from the same species, (3) is
expressed by a cell from a different species, or (4) does not occur
in nature.
The term "human antibody" includes all antibodies that have one or
more variable and constant regions derived from human
immunoglobulin sequences. In a preferred embodiment, all of the
variable and constant domains are derived from human immunoglobulin
sequences (a fully human antibody). These antibodies may be
prepared in a variety of ways, as described below.
A humanized antibody is an antibody that is derived from a
non-human species, in which certain amino acids in the framework
and constant domains of the heavy and light chains have been
mutated so as to avoid or abrogate an immune response in humans.
Alternatively, a humanized antibody may be produced by fusing the
constant domains from a human antibody to the variable domains of a
non-human species. Examples of how to make humanized antibodies may
be found in U.S. Pat. Nos. 6,054,297, 5,886,152 and 5,877,293,
incorporated herein by reference.
The term "chimeric antibody" refers to an antibody that contains
one or more regions from one antibody and one or more regions from
one or more other antibodies.
Fragments or analogs of antibodies can be readily prepared by those
of ordinary skill in the art following the teachings of this
specification. Preferred amino- and carboxy-termini of fragments or
analogs occur near boundaries of functional domains. Structural and
functional domains can be identified by comparison of the
nucleotide and/or amino acid sequence data to public or proprietary
sequence databases. Preferably, computerized comparison methods are
used to identify sequence motifs or predicted protein conformation
domains that occur in other proteins of known structure and/or
function. Methods to identify protein sequences that fold into a
known three-dimensional structure are known. Bowie et al. Science
253:164 (1991).
Small Interfering RNA
Small interfering RNA can also be used therapeutically to treat or
prevent GVHD, radiation induced diseases including GI syndrome,
inflammation and autoimmune diseases in a subject by administering
an si RNA at least a portion of which is complementary to and
specifically hybridizes with the mRNA encoding ASMase or Bax, in
order to reduce or inhibit the respective expression, thereby
blocking apoptosis.
US Patent Application 20040023390 (incorporated herein by
reference) teaches that double-stranded RNA (dsRNA) can induce
sequence-specific posttranscriptional gene silencing in many
organisms by a process known as RNA interference (RNAi). However,
in mammalian cells, dsRNA that is 30 base pairs or longer can
induce sequence-nonspecific responses that trigger a shut-down of
protein synthesis and even cell death through apoptosis. Recent
work shows that RNA fragments are the sequence-specific mediators
of RNAi (Elbashir et al., 2001). Interference of gene expression by
these small interfering RNA (siRNA) is now recognized as a
naturally occurring strategy for silencing genes in C. elegans,
Drosophila, plants, and in mouse embryonic stem cells, oocytes and
early embryos (Cogoni et al., 1994; Baulcombe, 1996; Kennerdell,
1998; Timmons, 1998; Waterhouse et al., 1998; Wianny and
Zernicka-Goetz, 2000; Yang et al., 2001; Svoboda et al., 2000).
In mammalian cell culture, a siRNA-mediated reduction in gene
expression has been accomplished by transfecting cells with
synthetic RNA nucleic acids (Caplan et al., 2001; Elbashir et al.,
2001). The 20040023390 application, the entire contents of which
are hereby incorporated by reference as if fully set forth herein,
provides methods using a viral vector containing an expression
cassette containing a pol II promoter operably-linked to a nucleic
acid sequence encoding a small interfering RNA molecule (siRNA)
targeted against a gene of interest.
As used herein RNAi is the process of RNA interference. A typical
mRNA produces approximately 5,000 copies of a protein. RNAi is a
process that interferes with or significantly reduces the number of
protein copies made by an mRNA. For example, a double-stranded
short interfering RNA (siRNA) molecule is engineered to complement
and match the protein-encoding nucleotide sequence of the target
mRNA to be interfered with. Following intracellular delivery, the
siRNA molecule associates with an RNA-induced silencing complex
(RISC). The siRNA-associated RISC binds the target mRNA (such as
mRNA encoding ASMase or Bax) through a base-pairing interaction and
degrades it. The RISC remains capable of degrading additional
copies of the targeted mRNA. Other forms of RNA can be used such as
short hairpin RNA and longer RNA molecules. Longer molecules cause
cell death, for example by instigating apoptosis and inducing an
interferon response. Cell death was the major hurdle to achieving
RNAi in mammals because dsRNAs longer than 30 nucleotides activated
defense mechanisms that resulted in non-specific degradation of RNA
transcripts and a general shutdown of the host cell. Using from
about 20 to about 29 nucleotide siRNAs to mediate gene-specific
suppression in mammalian cells has apparently overcome this
obstacle. These siRNAs are long enough to cause gene suppression
but not of a length that induces an interferon response.
The invention has been described in the foregoing specification
with reference to specific embodiments. It will however be evident
that various modifications and changes may be made to the
embodiments without departing from the broader spirit and scope of
the invention. The specification and drawings are to be regarded in
an illustrative rather than a restrictive sense.
Antisense Nucleic Acids
As used herein, the term "nucleic acid" refers to both RNA and DNA,
including cDNA, genomic DNA, and synthetic (e.g., chemically
synthesized) DNA. The nucleic acid can be double-stranded or
single-stranded (i.e., a sense or an antisense single strand). As
used herein, "isolated nucleic acid" refers to a nucleic acid that
is separated from other nucleic acid molecules that are present in
a mammalian genome, including nucleic acids that normally flank one
or both sides of the nucleic acid in a mammalian genome (e.g.,
nucleic acids that flank an ARPKD gene). The term "isolated" as
used herein with respect to nucleic acids also includes any
non-naturally-occurring nucleic acid sequence, since such
non-naturally-occurring sequences are not found in nature and do
not have immediately contiguous sequences in a naturally-occurring
genome.
An isolated nucleic acid can be, for example, a DNA molecule,
provided one of the nucleic acid sequences normally found
immediately flanking that DNA molecule in a naturally-occurring
genome is removed or absent. Thus, an isolated nucleic acid
includes, without limitation, a DNA molecule that exists as a
separate molecule (e.g., a chemically synthesized nucleic acid, or
a cDNA or genomic DNA fragment produced by PCR or restriction
endonuclease treatment) independent of other sequences as well as
DNA that is incorporated into a vector, an autonomously replicating
plasmid, a virus (e.g., a retrovirus, lentivirus, adenovirus, or
herpes virus), or into the genomic DNA of a prokaryote or
eukaryote. In addition, an isolated nucleic acid can include an
engineered nucleic acid such as a DNA molecule that is part of a
hybrid or fusion nucleic acid. A nucleic acid existing among
hundreds to millions of other nucleic acids within, for example,
cDNA libraries or genomic libraries, or gel slices containing a
genomic DNA restriction digest, is not to be considered an isolated
nucleic acid.
Other embodiments of the present invention are directed to the use
of antisense nucleic acids (either DNA or RNA) or small interfering
RNA to inhibit expression of ASMase or Bax or Bak or a biologically
active fragment or variant thereof. The antisense nucleic acid can
be antisense RNA, antisense DNA or small interfering RNA. Based on
the known sequence of ASMase or Bax or Bak, antisense DNA or RNA
that hybridize sufficiently to the respective gene or mRNA to turn
off expression can be readily designed and engineered using methods
known in the art.
The isolated antisense or siRNA nucleic acid molecules for use in
the invention comprise a nucleic acid molecule which is a
complement of the gene or mRNA sequence for the target: the gene
(full genomic DNA) encoding ASMasae, identified as SEQ ID NO: 1,
the gene encoding human Bax, identified as SEQ ID NO: 2, or the
gene encoding human Bak, identified as SEQ ID NO:3. A nucleic acid
molecule which is complementary to a given nucleotide sequence is
one which is sufficiently complementary to the given nucleotide
sequence that it can hybridize to the given nucleotide sequence
thereby forming a stable duplex.
Antisense nucleic acid molecules, i.e., molecules which are
complementary to a sense nucleic acid encoding a protein, e.g.,
complementary to the coding strand of a double-stranded DNA
molecule (or cDNA) or complementary to an mRNA sequence.
Accordingly, an antisense nucleic acid can hydrogen bond to a sense
nucleic acid. The antisense nucleic acid can be complementary to an
entire ASMase, Bak or Bax coding strand, or to only a portion
thereof, e.g., all or part of the protein coding region (or open
reading frame). An antisense nucleic acid molecule can be antisense
to a noncoding region of the coding strand of a nucleotide sequence
encoding ASMase, Bak or Bax. The noncoding regions ("5' and 3'
untranslated regions") are the 5' and 3' sequences which flank the
coding region and are not translated into amino acids.
Given the coding strand sequences encoding ASMase (cDNA SEQ ID NO.
2, GENOMIC DNA SEQ ID NO. 7, Bax cDNA SEQ ID NO. 3, GENOMIC DNA SEQ
ID NO. 8, or Bak cDNA SEQ ID NO. 5, GENOMIC DNA SEQ ID NO. 9
disclosed herein, antisense nucleic acids of the invention can be
designed according to the rules of Watson and Crick base pairing.
The antisense nucleic acid molecule can be complementary to the
entire coding region of ASMase, Bak or Bax mRNA, but more
preferably is an oligonucleotide which is antisense to only a
portion of the coding or noncoding region of ASMase, Bak or Bax
mRNA. For example, the antisense oligonucleotide can be
complementary to the region surrounding the translation start site
of ASMase, Bak or Bax. An antisense oligonucleotide can be, for
example, about 5, 10, 15, 20, 25, 30, 35, 40, 45 or 50 nucleotides
in length. An antisense nucleic acid of the invention can be
constructed using chemical synthesis and enzymatic ligation
reactions using procedures known in the art. For example, an
antisense nucleic acid (e.g., an antisense oligonucleotide) can be
chemically synthesized using naturally occurring nucleotides or
variously modified nucleotides designed to increase the biological
stability of the molecules or to increase the physical stability of
the duplex formed between the antisense and sense nucleic acids,
e.g., phosphorothioate derivatives and acridine substituted
nucleotides can be used. Examples of modified nucleotides which can
be used to generate the antisense nucleic acid include
5-fluorouracil, 5-bromouracil, 5-chlorouracil, 5-hodouracil,
hypoxanthine, xanthine, 4-acetylcytosine,
5-(carboxyhydroxylmethyl)uracil,
5-carboxymethylaminomethyl-2-thouridine,
5-carboxymethylaminometh-yluracil, dihydrouracil,
beta-D-galactosylqueosine, inosine, N6-isopentenyladenine,
1-methylguanine, 1-methylinosine, 2,2-dimethylguanine,
2-methyladenine, 2-methylguanine, 3-methylcytosine,
5-metnylcytosine, N6-adenine, 7-methylguanine,
5-methylaminomethyluracil, 5-methoxyaminomethyl-2-thiouracil,
beta-D-mannosylqueosine, 5'-methoxycarboxymethyluracil,
5-methoxyuracil, 2-methylthio-N6-isopenten-yladenine,
uracil-5-oxyacetic acid (v), wybutoxosine, pseudouracil, queosine,
2-thiocytosine, 5-methyl-2-thiouracil, 2-thlouracil, 4-thiouracil,
5-methyluracil, uracil-5-oxyacetic acid methylester,
uracil-5-cxyacetic acid (v), 5-methyl-2-thiouracil,
3-(3-amino-3-N-2-carboxypropyl) uracil, (acp3)w, and
2,6-diaminopurine. Alternatively, the antisense nucleic acid can be
produced biologically using an expression vector into which a
nucleic acid has been subcloned in an antisense orientation (i.e.,
RNA transcribed from the inserted nucleic acid will be of an
antisense orientation to a target nucleic acid of interest,
described further in the following subsection).
The antisense nucleic acid molecules of the invention are typically
administered to a subject or generated in situ such that they
hybridize with or bind to cellular mRNA and/or genomic DNA encoding
the protein of interest to thereby inhibit expression of the
protein, e.g., by inhibiting transcription and/or translation. The
hybridization can be by conventional nucleotide complementary to
form a stable duplex, or, for example, in the case of an antisense
nucleic acid molecule which binds to DNA duplexes, through specific
interactions in the major groove of the double helix. An example of
a route of administration of antisense nucleic acid molecules of
the invention include direct injection at a tissue site.
Alternatively, antisense nucleic acid molecules can be modified to
target selected cells and then administered systemically. For
example, for systemic administration, antisense molecules can be
modified such that they specifically bind to receptors or antigens
expressed on a selected cell surface, e.g., by linking the
antisense nucleic acid molecules to peptides or antibodies which
bind to cell surface receptors or antigens. The antisense nucleic
acid molecules can also be delivered to cells using the vectors
described herein. To achieve sufficient intracellular
concentrations of the antisense molecules, vector constructs in
which the antisense nucleic acid molecule is placed under the
control of a strong pol II or pol III promoter are preferred.
An antisense nucleic acid molecule of the invention can be an
alpha-anomeric nucleic acid molecule. An .alpha.-anomeric nucleic
acid molecule forms specific double-stranded hybrids with
complementary RNA in which, contrary to the usual .beta.-units, the
strands run parallel to each other (Gaultier et al. (1987) Nucleic
Acids. Res. 15:6625-6641). The antisense nucleic acid molecule can
also comprise a 2'-o-methylribonucleotide (Inoue et al. (1987)
Nucleic Acids Res. 15:6131-6148) or a chimeric RNA-DNA analogue
(Inoue et al. (1987) FEBS Lett. 215:327-330). All of the methods
described in the above articles regarding antisense technology are
incorporated herein by reference.
The invention also encompasses ribozymes. Ribozymes are catalytic
RNA molecules with ribonuclease activity which are capable of
cleaving a single-stranded nucleic acid, such as an mRNA, to which
they have a complementary region. Thus, ribozymes (e.g., hammerhead
ribozymes (described in Haselhoff and Gerlach (1988) Nature
334:585-591)) can be used to catalytically cleave ASMase, Bak or
Bax transcripts thereby inhibit translation of ASMase, Bak or Bax.
A ribozyme having specificity for an ASMase, Bak or Bax-encoding
nucleic acid can be designed based upon the nucleotide sequence of
a ASMase, Bak or BaxcDNA disclosed herein. For example, a
derivative of a Tetrahymena L-19 IVS RNA can be constructed in
which the nucleotide sequence of the active site is complementary
to the nucleotide sequence to be cleaved in an ASMase, Bak or
Bax-encoding mRNA. See, e.g., Cech et al. U.S. Pat. No. 4,987,071;
and Cech et al. U.S. Pat. No. 5,116,742. Alternatively, ASMase, Bak
or Bax mRNA can be used to select a catalytic RNA having a specific
ribonuclease activity from a pool of RNA molecules. See, e.g.,
Bartel and Szostak (1993) Science 261:1411-1418, incorporated
herein by reference.
As used herein, the term "nucleic acid" refers to both RNA and DNA,
including cDNA, genomic DNA, and synthetic (e.g., chemically
synthesized) DNA. The nucleic acid can be double-stranded or
single-stranded (i.e., a sense or an antisense single strand). As
used herein, "isolated nucleic acid" refers to a nucleic acid that
is separated from other nucleic acid molecules that are present in
a mammalian genome, including nucleic acids that normally flank one
or both sides of the nucleic acid in a mammalian genome (e.g.,
nucleic acids that flank an ARPKD gene). The term "isolated" as
used herein with respect to nucleic acids also includes any
non-naturally-occurring nucleic acid sequence, since such
non-naturally-occurring sequences are not found in nature and do
not have immediately contiguous sequences in a naturally-occurring
genome.
An isolated nucleic acid can be, for example, a DNA molecule,
provided one of the nucleic acid sequences normally found
immediately flanking that DNA molecule in a naturally-occurring
genome is removed or absent. Thus, an isolated nucleic acid
includes, without limitation, a DNA molecule that exists as a
separate molecule (e.g., a chemically synthesized nucleic acid, or
a cDNA or genomic DNA fragment produced by PCR or restriction
endonuclease treatment) independent of other sequences as well as
DNA that is incorporated into a vector, an autonomously replicating
plasmid, a virus (e.g., a retrovirus, lentivirus, adenovirus, or
herpes virus), or into the genomic DNA of a prokaryote or
eukaryote. In addition, an isolated nucleic acid can include an
engineered nucleic acid such as a DNA molecule that is part of a
hybrid or fusion nucleic acid. A nucleic acid existing among
hundreds to millions of other nucleic acids within, for example,
cDNA libraries or genomic libraries, or gel slices containing a
genomic DNA restriction digest, is not to be considered an isolated
nucleic acid.
Pharmaceutical Compositions
The present invention also includes pharmaceutical compositions and
formulations of the 2A2 humanized monoclonal antibody, optionally
formulated with one or more statins or imipramine. Other
pharmaceutical compositions include the antisense nucleic acids and
small interfering RNAs of the invention that are administered
reduce ASMase or Bak or Bax expression.
Pharmaceutical compositions of the present invention contain the
therapeutic agent (anti-ceramide antibody, enzyme inhibitors,
antisense nucleic acids or si RNA) in an amount sufficient to
prevent or treat the enumerated diseases: GVHD, radiation induced
diseases including GI syndrome, inflammation and autoimmune
diseases in a subject. These pharmaceutical compositions are
suitable for administration to a subject in need of prophylaxis or
therapy of GVHD, radiation induced diseases including GI syndrome,
inflammation and autoimmune diseases in a subject. The subject is
preferably a human but can be non-human as well. A suitable subject
can be an individual who is suspected of having, has been diagnosed
as having, or is at risk of developing one of the enumerated
diseases. Therapeutic compositions may contain, for example, such
normally employed additives as binders, fillers, carriers,
preservatives, stabilizing agents, emulsifiers, buffers and
excipients as, for example, pharmaceutical grades of mannitol,
lactose, starch, magnesium stearate, sodium saccharin, cellulose,
magnesium carbonate, and the like. These compositions typically
contain 1%-95% of active ingredient, preferably 2%-70% active
ingredient.
Antibodies and antisense nucleotides and enzyme inhibitors or
statins of the present invention can also be mixed with diluents or
excipients which are compatible and physiologically tolerable.
Suitable diluents and excipients are, for example, water, saline,
dextrose, glycerol, or the like, and combinations thereof. In
addition, if desired, the compositions may contain minor amounts of
auxiliary substances such as wetting or emulsifying agents,
stabilizing or pH buffering agents.
In some embodiments, the therapeutic compositions of the present
invention are prepared either as liquid solutions or suspensions,
as sprays, or in solid forms. Oral formulations usually include
such normally employed additives such as binders, fillers,
carriers, preservatives, stabilizing agents, emulsifiers, buffers
and excipients as, for example, pharmaceutical grades of mannitol,
lactose, starch, magnesium stearate, sodium saccharin, cellulose,
magnesium carbonate, and the like. These compositions take the form
of solutions, suspensions, tablets, pills, capsules, sustained
release formulations, or powders, and typically contain 1%-95% of
active ingredient, preferably 2%-70%. One example of an oral
composition useful for delivering the therapeutic compositions of
the present invention is described in U.S. Pat. No. 5,643,602
(incorporated herein by reference).
Additional formulations which are suitable for other modes of
administration, such as topical administration, include salves,
tinctures, creams, lotions, transdermal patches, and suppositories.
For salves and creams, traditional binders, carriers and excipients
may include, for example, polyalkylene glycols or triglycerides.
One example of a topical delivery method is described in U.S. Pat.
No. 5,834,016 (incorporated herein by reference). Other liposomal
delivery methods may also be employed (See, e.g., U.S. Pat. Nos.
5,851,548 and 5,711,964, both of which are herein incorporated by
reference).
The formulations may also contain more than one active compound as
necessary for the particular indication being treated, preferably
those with complementary activities that do not adversely affect
each other. Such molecules are suitably present in combination in
amounts that are effective for the purpose intended. For example,
the 2A2 antibody could be formulated with a statin or with
imipramine.
Sustained-release preparations may also be prepared. Suitable
examples of sustained release preparations include semipermeable
matrices of solid hydrophobic polymers containing the antibodies or
fragments, nystatin, imipramine or combinations thereof, which
matrices are in the form of shaped articles, e.g., films, or
microcapsule. Examples of sustained-release matrices include, but
are not limited to, polyesters, hydrogels (for example, poly
(2-hydroxyethyl-methacrylate), or poly (vinylalcohol)),
polylactides, copolymers of L-glutamic acid and y
ethyl-L-glutamate, non-degradable ethylene-vinyl acetate,
degradable lactic acid-glycolic acid copolymers such as the LUPRON
DEPOT (injectable microspheres composed of lactic acid-glycolic
acid copolymer and leuprolide acetate), and
poly-D-(-)-3-hydroxybutyric acid. While polymers such as
ethylene-vinyl acetate and lactic acid-glycolic acid enable release
of molecules for over 100 days, certain hydrogels release proteins
for shorter time periods.
The antibodies and antisense or siRNAs of the present invention may
be administered by any suitable means, including parenteral,
subcutaneous, topical, intraperitoneal, intrapulmonary, and
intranasal, and, intralesional administration (e.g. for local
immunosuppressive treatment). Parenteral infusions include
intramuscular, intravenous, intraarterial, intraperitoneal, or
subcutaneous administration. In addition suitable administration
includes by pulse infusion, particularly with declining doses of
the antibody. Preferably, the dosing is given by injections, most
preferably intravenous or subcutaneous injections, depending in
part on whether the administration is brief or chronic.
For the prevention or treatment of disease, the appropriate dosage
of antibody will depend on the type of disease to be treated, the
severity and course of the disease, whether the drug is
administered for preventive or therapeutic purposes, previous
therapy, the patient's clinical history and response to the new
drugs (2A2 antibody, etc.) and the discretion of the attending
physician. The antibodies and nucleotides or other drugs
(imipramine and statins) are suitably administered to the patient
at one time or over a series of treatments.
As mentioned above, the amount of anti-ceramide antibody to be
administered therapeutically ranges from about 1 ug to 100 ug/ml.
This amount typically varies and can be an amount sufficient to
achieve serum therapeutic agent levels typically of between about 1
microgram per milliliter and about 10 micrograms per milliliter in
the subject. The therapeutic agents of the invention can be
administered by one or more separate administrations, or by
continuous infusion. For repeated administrations over several days
or longer, depending on the condition, the treatment is sustained
until the symptoms are sufficiently reduced or eliminated. The
progress of this therapy is easily monitored by conventional
techniques and assays, and may be used to adjust dosage to achieve
a therapeutic effect.
A candidate dosage of antisense nucleic acid or siRNA for use
therapeutically can be determined initially by finding an amount
that reduces expression of the target protein in a biological
sample from a human or animal.
In the foregoing specification, the invention has been described
with reference to specific embodiments thereof. It will, however,
be evident that various modifications and changes may be made
thereto without departing from the broader spirit and scope of the
invention. The specification and drawings are, accordingly, to be
regarded in an illustrative rather than a restrictive sense.
EXAMPLES
Example 1: Materials & Methods
Cell Culture and Stimulation
Wild-type (clone E6-1), caspase 8.sup.-/- (clone 19.2) and
FADD.sup.-/- (clone 12.1) Jurkat T lymphocytes were obtained from
ATCC (Rockville, Md.). Cells were grown in a 5% CO.sub.2 incubator
at 37.degree. C. in RPMI 1640 medium supplemented with 10%
heat-inactivated fetal bovine serum and 10 mM Hepes (pH 7.4), 2 mM
L-glutamine, 1 mM sodium pyruvate, 100 .mu.M nonessential amino
acids, 100 units/ml penicillin, and 100 .mu.g/ml streptomycin.
Prior to stimulation with UV-C or anti-Fas, cells were resuspended
in fresh medium and allowed to acclimate for 4 hours. Jurkat cells
were then treated with 50 ng/ml anti-FasCH-11 activating antibody
(Upstate Biotechnology, Lake Placid N.Y.) or 50 Joules/m.sup.2 UV-C
using an FB-UVXL-1000 Crosslinker (Fisher Biotech, Pittsburgh Pa.),
unless otherwise indicated. For platform studies, Jurkat cells were
incubated with CH-11 at 4.degree. C. for 20 min to insure uniform
receptor
engagement, and warmed to 37.degree. C. to initiate
stimulation.
Where indicated, cells were pre-incubated with 10 .mu.M z-VAD-fmk
(Calbiochem, La Jolla Calif.), 30 .mu.g/ml nystatin (Sigma-Aldrich,
Milwaukee Wis.), 50 .mu.M imipramine (Sigma-Aldrich) or 1 .mu.g/ml
mouse monoclonal anti-ceramide antibody MID15B4 (Alexis
Biochemicals, San Diego Calif.). Nystatin, imipramine and
anti-ceramide studies were performed in RPMI containing 0.5%
lipid-free fetal bovine serum (HyClone, Logan Utah). In each study,
an aliquot of cells were stained with trypan blue to assess
viability.
Mice and Bone Marrow Transplantation (BMT)
C3H/HeJ, C3HeB/FeJ, LP/J ("LP," H-2b), B10.BR ("B10," H-2.sup.k)
and B6.MRL.lpr female mice, 8-12 weeks old, were purchased from
Jackson Laboratories (Bar Harbor, Me.). SV129/C57BL/6.sup.asmase-/-
and C57BL/6.sup.Bax-/- mice were inbred in our colony and genotyped
as previously described [Horinouchi, 1995 #171; Knudson, 1995
#173]. Backcrossing the asmase.sup.-/- genotype onto the C57BL/6
background was performed by initially mating wildtype C57BL/6
females with male SV129/C57BL/6.sup.asmase-/- mice. Male F.sub.1
mice with asmase.sup.+/- genotype were subsequently mated with
C57BL/6 females. Thereafter, a mating protocol of male
asmase.sup.+/- progeny with wildtype C57BL/6 female mice was
continued for ten generations to obtain an asmase.sup.+/- genotype
in pure C57BL/6 background. Once backcrossing was established,
C57BL/6.sup.asmase+/- mice were interbred to obtain experimental
animals. Male and female hosts were used in BMT experiments at 8-12
weeks of age. BMT protocols were approved by the Memorial
Sloan-Kettering Cancer Center Institutional Animal Care and Use
Committee. Mice were housed in a pathogen-free facility at Memorial
Sloan-Kettering Cancer Center in sterilized micro-isolator cages
and received normal chow and autoclaved hyperchlorinated drinking
water (pH 3.0). This facility is approved by the American
Association for Accreditation of Laboratory Animal Care and is
maintained in accordance with the regulations and standards of the
United States Department of Agriculture and the Department of
Health and Human Services, National Institutes of Health.
Bone marrow (BM) cells were removed aseptically from femurs and
tibias. Donor marrow was T-cell depleted using anti-Thy-1.2
antibody and low-TOX-M rabbit complement (Cedarlane Laboratories,
Hornby, Canada). Splenic T cells were obtained by purification over
a nylon wool column. Cells (5.times.10.sup.6 BM cells with or
without splenic T cells) were resuspended in Dulbecco's modified
essential medium and transplanted by tail-vein infusion into
lethally-irradiated recipients that had received 1100 cGy total
body irradiation (.sup.137Cs source) as a split dose with 3 hrs
between doses on day 0.
Cell culture medium for lymphocyte and bone marrow harvesting
consisted of RPMI 1640 supplemented with 10% heat-inactivated fetal
calf serum, 100 U/mL penicillin, 100 .mu.g/mL streptomycin, 2 mM
L-glutamine, and 50 .mu.M 2-mercaptoethanol. Anti-murine CD16/CD32
Fc block (2.4G2), fluorochrome-labeled CD3 (145-2C11), CD4 (RM4-5),
CD8 (53-6.7), CD62L (MEL-14), and Ly-9.1 (30C7) antibodies were
obtained from Pharmingen (San Diego, Calif.). Ammonium chloride red
blood cell (RBC) lysis buffer, concanavalin A (conA) and
concanamycin A (CMA) were obtained from Sigma (St. Louis, Mo.).
Ex Vivo Hepatocyte Culture
Hepatocytes were isolated by cannulation of the portal vein and
retrograde in situ collagenase perfusion according to the method
described by Klaunig94. Briefly, livers were perfused with 20 mL
Buffer 1 (Krebs Ringer with glucose+0.1 mM EGTA) followed by 25 mL
Buffer 2 [Krebs Ringer with glucose containing 0.2 mM CaCl2 with
5,000 units collagenase type I (Sigma)] at a rate of 7 ml/min by
peristaltic pump (Rainin Instrument LLC. Woburn, Mass.). Perfused
livers were excised and minced in Buffer 2, filtered through a 100
.quadrature.M cell strainer, washed twice at 50.times.g and
resuspended in RPMI 1640 complete medium containing 10% fetal
bovine serum. Viability was routinely greater than 90%.
Apoptosis Quantitation
Apoptosis was assessed in vitro by two different techniques. TUNEL
staining was performed on cells permeabilized with 0.1% Triton
X-100 and 0.1% sodium citrate at 4.degree. C. for 5 min, according
to the manufacturer's instructions (Roche Molecular Biochemicals,
Indianapolis Ind.). Alternately, stimulated cells were fixed with
2% paraformaldehyde, washed with phosphate buffered saline (PBS),
and stained with 100 .mu.l of 24 .mu.g/ml bis-benzimide
trihydrochloride solution (Hoechst #33258; Sigma-Aldrich, Milwaukee
Wis.) for 10 min. Morphologic changes of nuclear apoptosis
including chromatin condensation, segmentation and compaction along
the periphery of the nucleus or the appearance of apoptotic bodies
were quantified using an Axiovert S-100 Zeiss fluorescence
microscope as previously described.sup.33. A minimum of 200 cells
were examined per point.
Apoptosis was quantified in vivo in the endothelium of the lamina
propria of the small intestines following TUNEL staining as
described [Paris, 2001 #7]. Endothelial cells were identified by
immunostaining using an antibody against the endothelial cell
surface marker CD31 (PharMingen catalog no. 1951D) as previously
published [Paris, 2001 #7].
Hepatocyte apoptosis was assessed on 0.5.times.10.sup.6 hepatocytes
rested for 30 min in complete medium and stimulated for 16 hrs at
37.degree. C. in 5% CO.sub.2 with 1 .mu.g/mL anti-Fas Jo2 antibody
(Pharmingen) or 0-2.times.10.sup.6 splenic T cells isolated from
C57BL/6 mice 2-3 weeks following transplantation of LP/J donor bone
marrow and T cells as described. In some studies, hepatocytes were
pretreated for 30 min with nystatin (50 g/mL, Sigma-Aldrich,
Milwaukee Wis.), washed in RPMI, and resuspended in RPMI
supplemented with 1% lipid-free FBS prior to stimulation.
Clonogenic Assay
Colony formation of Jurkat cells following UV-C or anti-Fas CH-11
treatment was evaluated using a soft agar cloning assay as
described previously.sup.95. Briefly, cells were preincubated with
nystatin and anti-ceramide mAb, or vehicle and control IgM in
RPMI+0.5% lipid-free fetal bovine serum, and stimulated with
increasing doses of UV-C or anti-Fas for 4 hours. Subsequently,
cells were suspended in RPMI medium containing 20% FBS, 20 mM
L-glutamine and 40% methylcellulose medium, and plated in
triplicate. After 14-16 days of incubation, plates were analyzed by
inverted microscope and aggregates with more than 20 cells were
scored as colonies. Colony formation for each condition calculated
in relation to values obtained for untreated control cells. Colony
survival curves were calculated by least square regression
analysis, using a modification of the FIT software program.sup.96.
The program fits the curves by iteratively weighted least squares
to each set of dose-survival data, estimates the covariates of the
survival curve parameters and the corresponding confidence regions,
and plots the survival curve. It also derives curve parameters,
such as the D.sub.o (the reciprocal of the slope on the exponential
portion of the curve, representing the level of radiosensitivity)
and the N number (measuring the size of the shoulder).
Platform Detection
Platforms were detected as previously described. Briefly,
1.times.10.sup.6 Jurkat cells were stimulated with UV-C or
.alpha.-Fas, fixed with 2% paraformaldehyde at the indicated times,
blocked in PBS containing 1% fetal bovine serum, and then washed
with PBS. Cells were stained for the raft-localized lipid GM1 with
FITC-conjugated cholera toxin .beta.-subunit (2 gg/ml;
Sigma-Aldrich) for 45 min at 4.degree. C., washed twice in PBS
containing 0.1% Triton X-100 and mounted in fluorescent mounting
medium (Dako, Carpenteria Calif.). Fluorescence was detected using
an Axiovert S-100 Zeiss fluorescence microscope equipped with a
SPOT digital camera. The percentage of cells containing platforms,
i.e. those in which the fluorescence condenses onto less than 15%
of the cell surface, was determined by counting 150-250 cells per
point. Alternately, platforms were identified using a mouse
monoclonal anti-ceramide antibody MID 15B4 IgM (1:50 dilution,
Alexis Biochemicals), mouse monoclonal anti-Fas CH-11 IgM (1:500
dilution, Upstate Biotechnology) or polyclonal rabbit anti-ASMase
antibody 1598 (1:100 dilution) and detected using Cy3-conjugated
anti-mouse or anti-rabbit IgM (1:500 dilution, Roche Molecular
Biochemicals), respectively. Rabbit polyclonal anti-CD46 (1:1000
dilution, Santa Cruz Biotechnology, Santa Cruz Calif.) was used as
a negative control. In some studies, confocal images were obtained
using a Leica TCS SPZ upright confocal microscope. Alternatively,
0.5.times.10.sup.6 hepatocytes were stimulated for the indicated
times with CTLs and platform formation was assessed as
described.
The rabbit polyclonal anti-ASMase antibody #1598 was generated
against full-length FLAG-tagged human ASMase protein. Anti-sera was
purified over a BIO-RAD T-Gel Column to obtain an IgG fraction that
displays specific immunoreactivity by immunoblot assay at a
concentration of 100 ng/.mu.l towards 100 ng of purified
recombinant human ASMase or ASMase from 25 .mu.g of Jurkat cell
lysates. At a concentration of 200 .mu.g/.mu.l, #1598
quantitatively immunoprecipitates ASMase activity from 100 ng of
purified ASMase and at a concentration of 200 ng/.mu.l detects cell
surface expression of ASMase by flow cytometry or confocal
immunofluorescence microscopy.
Diacylglycerol Kinase Assay (DGK)
Jurkat cells, stimulated with UV-C or CH-11, were incubated for the
indicated times at 37.degree. C. Stimulation was terminated by the
addition of 2 ml of chloroform:methanol:HCl (100:100:1, v/v/v), and
ceramide was quantified by the diacyglycerol kinase assay, as
described.sup.97.
Western Blot Analysis
Jurkat cells stimulated with UV-C or CH-11 were incubated for the
indicated times at 37.degree. C. Stimulation was terminated with
ice-cold PBS and cells were lysed in RIPA buffer (25 mM HEPES (pH
7.4), 0.1% SDS, 0.5% sodium deoxycholate, 1% Triton X-100, 100 mM
NaCl, 10 mM NaF, 10 mM Na.sub.2P.sub.2O.sub.7, 10 mM EDTA and 10
.mu.g/ml each aprotonin and leupeptin). Samples were centrifuged at
14,000 g and the supernatants were added to 4.times.SDS-sample
buffer. Lysates were separated on a 10% SDS-PAGE gel and
transferred onto nitrocellulose membranes. Caspase cleavage was
detected using rabbit polyclonal antibodies against caspase 3 (BD
PharMingen, San Diego Calif.), caspase 8 (BD PharMingen) or caspase
9 (Cell Signaling Technology, Beverly Mass.). Caspase 8 and FADD
expression levels were detected using mouse monoclonal anti-caspase
8 (clone 1-1-37; Upstate Biotechnology) or anti-FADD (BD
PharMingen) antibodies, respectively.
Flow Cytometry Analyses
To detect surface ASMase by FACS, Jurkat cells were stimulated with
50 J/m.sup.2 UV-C or 50 ng/ml CH-11 at 37.degree. C. Stimulation
was terminated after 1 min, the time of maximal ASMase
translocation, by addition of ice-cold washing buffer (PBS
containing 1% FCS and 0.1% NaN.sub.3), and cells were blocked on
ice for 20 min using the same buffer supplemented with isotype
control rabbit IgG (20 .mu.g/ml). Cells were re-washed and
incubated for 45 min with 14 g/ml of polyclonal anti-ASMase 1598
antibody in PBS, followed by washing and incubation with Cy3
conjugated anti-rabbit IgG. 10,000 cells were analyzed using a
FACScan flow cytometer (Becton Dickinson, Franklin Lakes N.J.).
Harvested splenocytes were washed, incubated with CD16/CD32 FcR
block on ice for 15 min, subsequently incubated with primary
antibodies for 45 min, washed, resuspended in FACS buffer (PBS+2%
BSA+0.1% NaN.sub.3) and analyzed on a FACScan flow cytometer with
CellQuest software (Becton Dickinson). For CFSE staining, RBC-lysed
LP/J or B10.BR splenocytes were positively selected as per
manufacturer's instruction with anti-CD3 microbeads (Miltenyi,
Auburn, Calif.), stained in 2.5 .mu.M carboxyfluorescein diacetate
succinimidyl ester (CFSE) and 15-20.times.10.sup.6 stained cells
were transplanted into allogeneic (B6) recipients of either
asmase.sup.+/+ or asmase.sup.-/- background. Splenocytes from these
animals were harvested 72 hrs thereafter, stained with
fluorochrome-conjugated antibodies for surface antigens and FACS
analysis was carried out as above.
ASMase Activity Assay
ASMase activity was measured using a fluorescence-based,
high-performance liquid chromatographic (HPLC) assay.sup.98.
Briefly, 5.times.10.sup.6 Jurkat cells were stimulated with 50
J/m.sup.2 UV-C or 50 ng/ml CH-11 at 37.degree. C., and at the
indicated times washed with ice-cold PBS and lysed on ice in NP-40
buffer (150 mM NaCl, 25 mM Tris HCl pH 7.5, 10% glycerol, 1% NP-40,
2 mM EDTA, 0.1 M DTT supplemented with PMSF, leupeptin and protease
inhibitor cocktail). ASMase activity was measured by incubating an
equal volume of lysate in assay buffer [500 .mu.M BODIPY-C.sub.12
sphingomyelin (Molecular Probes, Eugene Oreg.), 0.1 mM ZnCl.sub.2,
0.1 M sodium acetate pH 5.0 and 0.6% Triton X-100] for 60 min at
37.degree. C. Thereafter, the reaction was stopped by 10.times.
dilution in ethanol and 5 .mu.l of the assay mixture was sampled by
a WIPS 712 (Waters Corp., Milford Mass.) auto-sampler equipped with
a 20.times.4 mm reverse-phase Aquasil C.sub.18 column (Keystone
Scientific, Bellefonte Pa.). The reaction product, BODIPY-C.sub.12
ceramide, was specifically separated from substrate within 0.4-0.5
min by isocratic elution with 95% MeOH at a flow rate of 1.2
ml/min. Fluorescence was quantified using a Waters 474 (Waters
Corp.) fluorescence detector set to excitation and emission
wavelengths of 505 and 540 nm, respectively. The amount of product
generated was calculated using a regression equation derived from a
standard curve established for known amounts of BODIPY-C.sub.12
ceramide standard. Alternatively, ASMase activity was quantified by
radioenzymatic assay using [.sup.14C-methylcholine]sphingomyelin
(Amersham Biosciences, Piscataway, N.J.) as substrate, as
described.sup.14. Briefly, Jurkat cells were lysed in PBS
containing 0.2% Triton X-100 at the indicated times after 50
J/m.sup.2 UV-C or 50 ng/ml CH-11 stimulation. Post nuclear
supernatants were assayed for activity in 250 mM sodium acetate, pH
5.0 supplemented with 0.1 mM ZnCl.sub.2, 1 mM EDTA and 0.1% Triton
X-100 in the presence of substrate. Reactions were terminated after
1 hour with CHCl.sub.3:MeOH: 1N HCl (100:100:1, v/v/v), and product
was quantified by scintillation counter. As both assays yielded
identical fold increases after UV-C or Fas stimulation, these data
were collated. However, BODIPY-C.sub.12 sphingomyelin was less
efficiently catalyzed resulting in a lower Vmax as determined by
Michaelis Menton kinetic analysis. Thus, baseline ASMase specific
activity, derived from the radioenzymatic assay, is displayed
throughout the manuscript.
Radiation and Tissue Preparation
TBI was delivered with a Shepherd Mark-I unit (Model 68, SN643)
operating .sup.137Cs sources. The dose rate was 2.12 Gy/min. To
collect small intestinal samples, mice were sacrificed by
hypercapnia asphyxiation and 2.5 cm segments of the proximal
jejunum were obtained at 2 cm from the ligament of Trietz. Tissue
samples were fixed by overnight incubation in 4% neutral buffered
formaldehyde and embedded in paraffin blocks. To evaluate
intestinal tissue responses to radiation, transverse sections of
the full jejunal circumference (5 .mu.m thick) were obtained by
microtomy from the paraffin blocks, adhered to polylysine-treated
slides and deparaffinized by heating at 90.degree. C. for 10
minutes and at 60.degree. C. for 5 minutes, followed by two xylene
washes for 5 minutes, and stained with hematoxylin and eosin
according to a standard protocol. To determine the causes of death
after TBI, autopsies were performed within 60 min of animal death
or when terminally-sick animals displaying an agonal breathing
pattern were sacrificed by hypercapnia asphyxiation. Tissue
specimens were collected from all animals, fixed in formaldehyde,
and stained with hematoxylin.
Crypt Microcolony Survival Assay
The microcolony survival assay was performed as described by
Withers and Elkind.sup.99. Briefly, 3.5 days after irradiation mice
were sacrificed by hypercapnia asphyxiation and samples of the
small intestine were harvested and prepared for histological
staining as described above. Surviving crypts were defined as
containing 10 or more adjacent chromophilic non-Paneth cells, at
least one Paneth cell and a lumen. The circumference of a
transverse cross section of the intestine was used as a unit. The
number of surviving crypts was counted in each circumference. 10-20
circumferences were scored per mouse and 2-4 mice were used to
generate each data point. Data were reported as mean.+-.SEM.
Assessment of GVHD
Survival was monitored daily, and ear-tagged animals in coded cages
were individually scored weekly for 5 clinical parameters (weight
loss, hunched posture, decreased activity, fur ruffling, and skin
lesions) on a scale from 0 to 2. A clinical GVHD score was
generated by summation of the 5 criteria scores (0-10) as described
by Cooke et al.sup.100. GVHD target organ pathology for bowel
(terminal ileum and ascending colon), liver and skin (tongue and
ear) was assessed by one individual (J.M.C. for liver and
intestinal pathology, G.F.M. for cutaneous pathology) in a blinded
fashion on 10% formalin-buffered phosphate-preserved,
paraffin-embedded and hematoxylin/eosin-stained 5 .mu.M
histopathology sections with a semiquantitative scoring system.
Briefly, bowel and liver were scored for 19 to 22 different
parameters associated with GVHD as described.sup.101 and skin was
evaluated for the number of dyskeratotic and apoptotic cells, as
published.sup.102 Villus and crypt cell apoptosis were scored on
formalin-preserved, paraffin-embedded, TUNEL-stained and
hematoxylin/eosin-counterstained sections, as
described.sup.18,62.
ELISA
Enzyme-linked immunosorbent assays (ELISA) for serum IL-1.beta.,
IL-2, IFN-.gamma. and TNF-.alpha. levels was performed according to
the manufacturer's instructions (R&D, Minneapolis, Minn.).
Activation-Induced Cell Death (AICD) Assay
Harvested splenocytes were enriched for T lymphocytes by nylon wool
passage, resulting in >90% purity based upon FITC-CD3 mAb
staining by flow cytometry. AICD was induced as previously
reported.sup.103. Briefly, T cells were incubated in RPMI 1640+10%
FCS at 2.times.10.sup.6/mL and primed with 10 .mu.g/ml ConA (Sigma,
St. Louis, Mo.) for 48 hrs. Cells were then washed and rested in
medium containing 20 U/mL L-2 (R&D Systems) for 24 hrs.
Finally, cells were washed and resuspended in medium containing 20
U/mL L-2 and increasing amounts of anti-CD3 mAb (0-10 .mu.g/ml) for
24 hrs. Cells were subsequently fixed, stained with 25 .mu.l of 24
.mu.g/ml bis-benzimide trihydrochloride solution (Hoechst #33258;
Sigma-Aldrich, Milwaukee Wis.) and apoptosis was quantified by
fluorescence microscopy, as above.
Mixed Lymphocyte Reactions (MLR)
Balb/c splenocytes were in vitro activated by incubation with
2.times.10.sup.6 irradiated (2000 rad) C57BL/6 splenocytes in RPMI
1640+10% FCS for 5 days. 2 days prior to the MLR, asmase.sup.+/+ or
asmase.sup.-/- splenocytes were activated with 10 .mu.g/mL con A
for 48 hrs, labeled for
45 min with 1 .mu.Ci/mL Na.sub.2 .sup.51Cr0.sub.4 at 37.degree. C.
and 5% CO.sub.2, washed in RPMI 1640+10% FBS, and coincubated with
activated Balb/c splenocytes in complete medium for 24 hrs at
37.degree. C. Target cell lysis was quantified by counting
.sup.51Cr release into the supernatant by gamma counter (Cobra,
Meriden, Conn.) using the formula corrected %
lysis=100.times.(sample .sup.51Cr release-control .sup.51Cr
release)/(maximum .sup.51Cr release-control .sup.51Cr release).
Statistics
Actuarial survival of animals was calculated by the product limit
Kaplan-Meier method.sup.104 and statistical significance of
differences in survival were calculated by the Mantel log-rank
test.sup.105. Crypt survival curves were calculated by least square
regression analysis, using a modification of the FIT software
program.sup.96. The program fits the curves by iteratively weighted
least squares to each set of dose-survival data, estimates the
covariates of the survival curve parameters and the corresponding
confidence regions, and plots the survival curve. It also derives
curve parameters, such as the D.sub.o (the reciprocal of the slope
on the exponential portion of the curve, representing the level of
radiosensitivity) and the N number (measuring the size of the
shoulder). Statistical analysis of GVHD scores, thymocyte and
splenocyte number, and proliferation assays was performed using the
nonparametric unpaired Mann-Whitney Utest. Student's t-test with
95% confidence estimations was used for all other analyses.
Example 2
Role of Asmase in GvHD
Small intestine, liver and skin were harvested from asmase.sup.+/+
and asmase.sup.-/- recipients 21 days following transplantation of
BM with or without 3.times.10.sup.6 T cells. Hematoxylin &
Eosin stained liver sections revealed hepatic GvHD, characterized
by lymphocyte infiltration (FIG. 22A, arrows), portal tract
inflammation, endotheliitis (FIG. 22A, right panels) and loss of
hepatic architecture was less prominent in asmase.sup.-/- compared
to asmase.sup.+/+ recipients. Similarly, intestinal GvHD, including
villus blunting, lamina propria inflammation, crypt stem cell loss
and destruction and mucosal atrophy were less prominent in
asmase.sup.-/- recipients (FIG. 22B, arrows indicate apoptotic
cells). Semiquantitative histopathologic analyses revealed that
asmase.sup.+/+ recipients of allogeneic bone marrow and T cells
scored significantly higher than littermates receiving only BM in
liver (Table 1, 15.7.+-.1.5 vs. 8.3.+-.2.7, p<0.05) and small
intestine (Table 2, 10.7.+-.1.1 vs. 3.5.+-.0.5, p<0.01). ASMase
deficiency largely protected GvHD-associated organ damage,
decreasing scoring to 10.2.+-.0.5 and 7.+-.0.1 in liver and small
intestines, respectively (Table 2, p<0.005 each for liver and
intestine vs. asmase.sup.+/+ littermates).
GvHD-associated organ injury is associated with prominent intestine
and skin apoptosis. TUNEL-stained ileum sections revealed prominent
incidence of apoptotic cells within the lamina propria (FIG. 22C)
and crypt epithelium (FIG. 22D) of asmase.sup.+/+ recipients of BM
and T cells. asmase.sup.+/+ recipients of allogeneic T cells
exhibited massive apoptosis (>4 apoptotic cells per villus) in
88.4% of villi, which was decreased to 25.4% in asmase.sup.-/-
recipients (FIG. 22C, p<0.05) and 3.8.+-.0.4 apoptotic
epithelial cells per crypt, attenuated to 0.95.+-.0.2 in
asmase.sup.-/- recipients (FIG. 22D, p<0.05). Further, ASMase
deficiency protected hosts from cutaneous keratinocyte apoptosis
following minor antigen-mismatched allogeneic BMT (FIG. 22E).
Allogeneic T cells induced 5.1.+-.0.9 apoptotic cells/mm in
asmase.sup.-/- epidermis, compared to 8.2.+-.2.1 apoptotic cells/mm
of asmase.sup.+/+ epidermis (p<0.05). These data demonstrate
that ASMase tissue are resistant to GvH-associated apoptosis and
organ injury, showing that ASMase regulates GvH-induced morbidity
and mortality by determining target organ injury and apoptosis. To
confirm a specific role for host ASMase in GvHD, a major
histocompatability-incompatible allogeneic BM transplantation model
of B10.BR donor (H-2.sup.k) into C57BL/6 recipient (H-2.sup.b) was
selected. Lethally-irradiated C57BL/6 hosts of ASMase.sup.+/+ or
ASMase.sup.-/- background received 10.times.10.sup.6 T-cell
depleted (TCD) B10.BR BM cells, and GvHD was induced by the
addition of 0.5.times.10.sup.6 B10.BR donor splenic T cells to the
allograft. Consistent with the minor-mismatched model,
significantly less target organ damage was observed in
asmase.sup.-/- hosts compared to asmase.sup.+/+ littermates 14 days
following transplantation of BM and T cells (Table 1, liver
pathology scores of 16.3.+-.1.1 in asmase.sup.+/+ vs. 7.4.+-.0.9 in
asmase.sup.-/- hosts, p<0.05, and small intestine pathology
scores of 10.0.+-.0.8 in asmase.sup.+/+ vs. 3.5.+-.0.4 in
asmase.sup.-/- hosts, p<0.05). These data are consistent with
diminished crypt epithelium apoptosis (59.3.+-.3.8% of crypts
containing apoptotic cells in wild type vs. 15.8.+-.3.7% in
asmase.sup.-/- hosts, p<0.05, not shown) and reduced hepatic
lymphocyte infiltration, endotheliitis and overall destruction of
the hepatic architecture (not shown). Further, keratinocyte
apoptosis was prominent in wild type hosts, reaching an apoptotic
index of 11.2.+-.1.2 apoptotic cells/mm.sup.2 epidermis that was
significantly attenuated in asmase.sup.-/- hosts to 3.2.+-.1.7
(FIG. 22E, p<0.01). However, Kaplan-Meier survival could not be
determined in this major mismatched model due to a late (>day 21
post BMT) BM aplasia, accredited to a genetic shift in the B10.BR
strain detected and described on the Jackson laboratory website.
Taken together, these data identify a significant attenuation of
GvHD-associated target organ damage and apoptosis, closely
correlating with protection against GvH morbidity and mortality, in
asmase.sup.-/- hosts compared to wild type littermates across both
minor and major antigen disparities.
TABLE-US-00003 TABLE 2 Host asmase.sup.-/- mediates graft-vs.-host
target organ injury and apoptosis. Major-Mismatch Minor-Mismatch
Model (B10.fwdarw.B6) Model (LP.fwdarw.B6) Small Transplan Liver
Liver Liver Intestine t BM 8.3 .+-. 2.7 8.3 .+-. 2.7 1.0 .+-. 0.0
2.0 .+-. 0.0 (asmase.sup.+/+ hosts) BM 7.1 .+-. 0.9 7.1 .+-. 0.9
0.7 .+-. 0.3 1.5 .+-. 0.5 (asmase.sup.-/- hosts) BM + T 15.7 .+-.
1.5* 15.7 .+-. 1.5* 16.3 .+-. 1.1* 10.0 .+-. 0.8* (asmase.sup.+/+
hosts) BM + T 10.2 .+-. 0.5** 10.2 .+-. 0.5** 7.4 .+-. 0.9** 3.5
.+-. 0.4 (asmase.sup.-/- hosts) C57BL/6 recipient hosts received LP
BM and T cells (minor mismatch) as described in FIG. 1, or
alternatively, received 10 .times. 10.sup.6 BM and 0.5 .times.
10.sup.6 T cells from B10.BR donors (major mismatch).
asmase.sup.+/+ and asmase.sup.-/- recipients were sacrificed 14
(B10. BR recipients) or 21 (LP recipients) days post BMT, and
tissues were harvested for histopathologic analysis. Small
intestine, large intestine and liver were scored for established
organ-specific parameters in a blinded fashion (mean .+-. SEM) for
4-14 animals per group. *indicates p < 0.01 vs. BM group
(asmase.sup.+/+ hosts), **indicates p < 0.01 vs. BM + T
(asmase.sup.+/+ hosts).
TABLE-US-00004 TABLE 3 BM BM BM + T BM + T asmase.sup.+/+
asmase.sup.-/- asmase.sup.+/+ asmase.sup.-/- hosts hosts hosts
hosts Minor-Mismatch Model (LP.quadrature.B6) IL-2 (pg/ml) 15.7
.+-. 4.1 13.0 .+-. 1.6 30.3 .+-. 2.8* 19.1 .+-. 2.0** IFN-.gamma.
(pg/ml) 3.7 .+-. 1.0 109.9 .+-. 18.9* 32.8 .+-. 12.4** 1.3 .+-. 0.4
IL-1.beta. (fg/ml) 6.8 .+-. 1.9 5.5 .+-. 0.5 13.4 .+-. 1.1* 2.9
.+-. 1.2** TNF-.alpha. (pg/ml) 2.3 .+-. 1.2 5.2 .+-. 1.0 24.3 .+-.
7.1* 17.3 .+-. 3.0 Major-Mismatch Model (B.10.quadrature.B6)
IFN-.gamma. (pg/ml) 4.1 .+-. 1.0 199.1 .+-. 14.2* 63.3 .+-. 10.8**
3.6 .+-. 1.9 TNF-.alpha. (pg/ml) 33.0 .+-. 1.9 136.8 .+-. 11.5*
63.7 .+-. 9.0** 16.7 .+-. 2.3
Table 3. Host Asmase.sup.-/- Regulates Graft-Vs.-Host-Induced Serum
Cytokine Expansion.
Host C57BL/6 were transplanted with LP/J TCD-BM with or without
splenic T cells as described in Example 1 and serum was obtained
from peripheral blood on day 7 post marrow transplant by
retro-orbital puncture. Serum Th1 (IL-2 and IFN-.gamma.) and Th2
(IL-1.beta. and TNF-.alpha.) cytokines levels were quantified by
ELISA, as described in Example 1. Serum cytokine levels
(mean.+-.SEM) compiled from 3-8 determinations from three
independent experiments for each group are depicted. * p<0.005
vs. BM; ** p<0.01 vs. asmase.sup.+/+.
Example 3
ASMase Deficiency Protects Against Inflammation
We next conducted experiments showing that host ASMase inactivation
attenuates Th1/Th2 cytokine profile and CD8.sup.+ T cell
proliferation in acute GvHD. Initial CTL-mediated tissue damage
propagates a feed-forward response requiring CD4.sup.+ Th1 cytokine
secretion and consequent alloreactive CD8.sup.+ clonal expansion
for acute GvHD to proceed, followed by inflammatory cytokine storm.
To assess the impact of ASMase on serum cytokine levels during
GvHD, serum Th1 cytokines IL-2 And IFN-.gamma. and Th2 cytokines
IL-1.beta. and TNF-.alpha. were quantified 7 and 14 days following
transplantation of LP BM with or without splenic T cells. In the
minor mismatched model, addition of T cells to the allograft
increased IL-2 and IFN-.gamma. from 15.7.+-.4.1 to 30.3.+-.2.8 and
3.7.+-.1.0 to 109.9.+-.18.9 pg/ml serum, respectively (p<0.05
for each) on day 7 compared to BM control recipients (Table 3). Th2
cytokines IL-1.beta. and TNF-.alpha. similarly increased from
6.8.+-.1.9 to 13.4.+-.1.1 and 2.3.+-.1.2 to 24.3.+-.7.0 pg/ml
serum, respectively (p<0.05 for each) on day 7 compared to BM
control recipients (Table 3). Genetic inactivation of host ASMase
reduced serum IL-2 and IFN-.gamma. to 19.1.+-.2.0 and 32.8.+-.12.4
pg/ml serum, respectively, (p<0.05 vs. asmase.sup.+/+ hosts) and
IL-1.beta. and TNF-.alpha. to 2.9.+-.1.2 and 17.3.+-.3.0 pg/ml
serum, respectively, (p<0.05 vs. asmase.sup.+/+ hosts and not
significant) on day 7 (Table 3). Attenuation of serum cytokines was
preserved across major mismatched model of donor B10.BR BM and T
cells into C57BL/6 hosts (Table 2, 199.1.+-.14.2 vs. 63.3.+-.10.8
pg/ml IFN-.gamma. in asmase.sup.+/+ vs. asmase.sup.-/- hosts
p<0.05, 136.8.+-.11.5 vs. 63.7.+-.9.0 pg/ml TNF-.alpha. in
asmase.sup.+/+ vs. asmase.sup.-/- hosts p<0.005), demonstrating
that ASMase deficiency generally attenuated serum cytokine
production in recipients of allogeneic BM and T cells.
Increased serum cytokine levels directly impact T cell
expansion.sup.111. To assess whether attenuation of serum cytokines
in asmase.sup.-/- recipients of BM and T cells impacts donor T cell
proliferation, carboxyl fluorescein succinimidyl ester
(CFSE)-labeled T cells (10-20.times.10.sup.6) from LP/J (H-2.sup.b,
Minor MHC-incompatible) or B10.BR (H-2.sup.k, Major
MHC-incompatible) donors were infused into lethally-irradiated
C57BL/6 hosts of asmase.sup.+/+ or asmase.sup.-/- background. While
in vivo expansion of both LP and B10.BR CD4.sup.+ T cells were not
statistically different in asmase.sup.-/- compared to
asmase.sup.+/+ littermates (FIG. 23A upper panels and not shown for
B10.BR), CD8.sup.+ T cell proliferation was significantly impaired
across both minor (FIG. 12A) and major MHC (not shown) disparate
models. Three days following infusion, proliferating CD8.sup.+
cells constituted 54.1% of the total donor LP CD8.sup.+ T cell
population in asmase.sup.+/+ hosts, compared to 26.4% of the
population recovered from asmase.sup.-/- hosts (FIG. 23A lower
panels, p<0.005). Similarly, proliferating donor B10.BR
CD8.sup.+ cells were reduced from 81.5% of the total population in
asmase.sup.+/+ hosts to 67.1% in asmase.sup.-/- hosts (not shown,
p<0.005). Further, attenuated proliferation resulted at 14 days
following infusion of BM and 3.times.10.sup.6 T cells in
significant reduction of splenic donor LP/J CD8.sup.+ T cells from
1.69.+-.0.28.times.10.sup.6 cells in asmase.sup.+/+ recipients to
0.55.+-.0.28.times.10.sup.6 in asmase.sup.-/- recipients, (FIG.
23B, p<0.001).
Despite impairment of proliferation in vivo, T cell proliferative
capacity remained intact upon transplantation into asmase.sup.-/-
hosts, as splenic T cells from asmase.sup.-/- or asmase.sup.+/+
hosts allografted with LP/J TCD-BM and T cells displayed similar
specific proliferative responses ex vivo when challenged with conA
(FIG. 24). T cell proliferative capacity remains intact in
asmase.sup.-/- hosts. Thymidine incorporation assay measuring
proliferation of splenic T cells harvested from
C57BL/6.sup.asmase+/+ or C57BL/6.sup.asmase-/- recipients of donor
LP BM and T cells in response to syngeneic (LP) or allogeneic
(Balb/c) splenocytes or mitogen (ConA). Data (mean.+-.SEM)
represent triplicate determinations from three independent
experiments).
Further, ex vivo alloactivation of T cells derived from
asmase.sup.+/+ and asmase.sup.-/- hosts 21 days post
transplantation with LP/J BM+T cells were similar, as proliferation
was intact in response to irradiated third party T cell challenge
(Balb/c), and absent in response to irradiated LP/J T cells (FIG.
23). These data demonstrate deficient in vivo CD8.sup.+ CTL
proliferation in asmase.sup.-/- hosts, and show a
biologically-relevant consequence to the attenuation of serum
proinflammatory cytokine levels in these BMT recipients.
Example 4
Methods for Making 2A2 Antibody
Hybridoma Generation
C57BL/6 mice underwent eight immunizations with Kaposi's Sarcoma
cells, and serum was collected for evaluation by ELISA.
Alternatively, mice were immunized with BSA-conjugated
C.sub.16-ceramide. Serum was tested for ceramide-binding by ELISA,
and animals testing positive were sacrificed. Peripheral lymph
nodes were harvested and macerated to release B cells. PEG mediated
fusion was performed on the purified B cells using Sp2/0 myeloma
cells, and the fusions were plated in culture plates containing
HAT-supplemented DMEM. Hybridomas were subsequently fed on day 5,
and supernatants were collected on day 10 and tested for ceramide
binding by ELISA. Clones were determined positive only if
supernantants bound ceramide but not BSA or
C.sub.16-dihydroceramide. Positive clones were expanded in
HT-supplemented DMEM, subcloned by limiting dilution, and
re-evaluated by ELISA.
ELISA Assay
Antigen (BSA-conjugated C.sub.16 ceramide, BSA-conjugated C.sub.16
dihydroceramide or BSA) was absorbed onto a NUNC Maxisorp
Immunoplate by incubation overnight at 4.degree. C. Unbound antigen
was washed by phosphate buffered saline (PBS) containing 0.05%
Tween20, and plates were saturated with PB S containing 5% milk.
Hybridoma supernatant or primary antibody incubation was performed
for 2 hrs at room temperature. Following 3 washes in PBS+0.05%
Tween20, secondary antibody incubation (HRP-conjugated anti-mouse
antibody) was performed for 2 hrs at room temperature. Following an
additional 3 washes, antibody binding was detected using
3,3',5,5'-tetramethylbenzidine (TMB), stopped using an acidic
solution and absorbance was quantified at 450 nm.
Antibody Purification
Tissue culture supernatants from hybridomas were sterile filtered
and mixed with pre-washed protein G for 1 hr at 4.degree. C.
Protein G was collected and washed with 10 volumes of PBS.
Antibodies were eluted with 50 mM citrate, 140 mM NaCL, pH 2.7.
Antibody containing fractions were neutralized by Tris, dialyzed
and antibody was purified by column affinity. Antibody was eluted
using NaCL gradient. Antibody was dialyzed against 25 mM phosphate,
100 mM NaCL, pH 5.8, aliquoted at 1 mg/ml and stored at -20.degree.
C.
Methods for Making 2A2 Antibody
Generation of Monoclonal Antibodies.
Five 8-week-old female BALB/c mice were immunized with 0.5 ml of
Kaposi Sarcoma cells (4.times.10.sup.7/ml) via IP. The animals were
immunized three times, once per week. Mice were bled 1 week after
the last immunization, and the antibody responses in the antiserum
were evaluated by FACS analysis. One mouse was chosen for hybridoma
preparation. It received an additional boost of KS cells three days
before the cell fusion. Splenocytes from the BALB/c mice immunized
with KS cells were fused with mouse myeloma cells (P3X63Ag8.653,
ATCC) at a 4:1 ratio using polyethylene glycol (MW 1500). After
fusion, cells were seeded and cultured in 96-well plates at
1.times.10.sup.5 cells/well in the RPMI 1640 selection medium
containing 20% fetal bovine serum, 10% Hybridoma supplements
(Sigma), 2 mM L-glutamine, 100 U/ml penicillin, 100 mg/ml
streptomycin, 10 mM HEPES, and 1.times.
hypoxanthine-aminopterin-thymidine (Sigma). Hybridoma supernatants
were screened by FACS analysis on KS cells and ELISA using
commercial available proteins mixture (Annexin V, Ceramide-BSA and
APA). Selected hybridomas were subcloned four times by limited
dilution and screened by ELISA on Annexin V coated plates.
Conditional media were harvested from the stable hybridoma
cultures. The Ig class of mAb was determined with a mouse mAb
isotyping kit (Santa Cruz). 2A2 mIgM was purified from ascites by
using an immobilized mannan binding protein beads. 2A2 mAb (mIgM)
that bind to Annexin V has weak cross-binding activity to Ceremide
was confirmed by ELISA.
Antibody Humanization.
General molecular cloning techniques (RT-PCR or 5'-RACE) are used
to obtain the variable regions for both heavy (V.sub.H) and light
(V.sub.L) chains of a murine 2A2 antibody. A chimeric 2A2 antibody
will be generated to confirm binding properties equivalent to that
of the murine parent. Chimeric 2A2 antibody will be humanized by
using complementarity determining region (CDR) grafting. The human
framework sequences from the set of human germ line genes will be
chosen based on similarity of the human antibody's CDRs to the
mouse 2A2 antibody's CDRs. The antibody will be further engineered
to fine tune the structure of the antigen-binding loops by
replacing key residues in the framework regions of the antibody
variable regions to improve antibody affinity and production.
SEQUENCE LISTINGS
1
91631PRTHomo sapiens 1Met Pro Arg Tyr Gly Ala Ser Leu Arg Gln Ser
Cys Pro Arg Ser Gly1 5 10 15Arg Glu Gln Gly Gln Asp Gly Thr Ala Gly
Ala Pro Gly Leu Leu Trp 20 25 30Met Gly Leu Val Leu Ala Leu Ala Leu
Ala Leu Ala Leu Ala Leu Ala 35 40 45Leu Ser Asp Ser Arg Val Leu Trp
Ala Pro Ala Glu Ala His Pro Leu 50 55 60Ser Pro Gln Gly His Pro Ala
Arg Leu His Arg Ile Val Pro Arg Leu65 70 75 80Arg Asp Val Phe Gly
Trp Gly Asn Leu Thr Cys Pro Ile Cys Lys Gly 85 90 95Leu Phe Thr Ala
Ile Asn Leu Gly Leu Lys Lys Glu Pro Asn Val Ala 100 105 110Arg Val
Gly Ser Val Ala Ile Lys Leu Cys Asn Leu Leu Lys Ile Ala 115 120
125Pro Pro Ala Val Cys Gln Ser Ile Val His Leu Phe Glu Asp Asp Met
130 135 140Val Glu Val Trp Arg Arg Ser Val Leu Ser Pro Ser Glu Ala
Cys Gly145 150 155 160Leu Leu Leu Gly Ser Thr Cys Gly His Trp Asp
Ile Phe Ser Ser Trp 165 170 175Asn Ile Ser Leu Pro Thr Val Pro Lys
Pro Pro Pro Lys Pro Pro Ser 180 185 190Pro Pro Ala Pro Gly Ala Pro
Val Ser Arg Ile Leu Phe Leu Thr Asp 195 200 205Leu His Trp Asp His
Asp Tyr Leu Glu Gly Thr Asp Pro Asp Cys Ala 210 215 220Asp Pro Leu
Cys Cys Arg Arg Gly Ser Gly Leu Pro Pro Ala Ser Arg225 230 235
240Pro Gly Ala Gly Tyr Trp Gly Glu Tyr Ser Lys Cys Asp Leu Pro Leu
245 250 255Arg Thr Leu Glu Ser Leu Leu Ser Gly Leu Gly Pro Ala Gly
Pro Phe 260 265 270Asp Met Val Tyr Trp Thr Gly Asp Ile Pro Ala His
Asp Val Trp His 275 280 285Gln Thr Arg Gln Asp Gln Leu Arg Ala Leu
Thr Thr Val Thr Ala Leu 290 295 300Val Arg Lys Phe Leu Gly Pro Val
Pro Val Tyr Pro Ala Val Gly Asn305 310 315 320His Glu Ser Thr Pro
Val Asn Ser Phe Pro Pro Pro Phe Ile Glu Gly 325 330 335Asn His Ser
Ser Arg Trp Leu Tyr Glu Ala Met Ala Lys Ala Trp Glu 340 345 350Pro
Trp Leu Pro Ala Glu Ala Leu Arg Thr Leu Arg Ile Gly Gly Phe 355 360
365Tyr Ala Leu Ser Pro Tyr Pro Gly Leu Arg Leu Ile Ser Leu Asn Met
370 375 380Asn Phe Cys Ser Arg Glu Asn Phe Trp Leu Leu Ile Asn Ser
Thr Asp385 390 395 400Pro Ala Gly Gln Leu Gln Trp Leu Val Gly Glu
Leu Gln Ala Ala Glu 405 410 415Asp Arg Gly Asp Lys Val His Ile Ile
Gly His Ile Pro Pro Gly His 420 425 430Cys Leu Lys Ser Trp Ser Trp
Asn Tyr Tyr Arg Ile Val Ala Arg Tyr 435 440 445Glu Asn Thr Leu Ala
Ala Gln Phe Phe Gly His Thr His Val Asp Glu 450 455 460Phe Glu Val
Phe Tyr Asp Glu Glu Thr Leu Ser Arg Pro Leu Ala Val465 470 475
480Ala Phe Leu Ala Pro Ser Ala Thr Thr Tyr Ile Gly Leu Asn Pro Gly
485 490 495Tyr Arg Val Tyr Gln Ile Asp Gly Asn Tyr Ser Gly Ser Ser
His Val 500 505 510Val Leu Asp His Glu Thr Tyr Ile Leu Asn Leu Thr
Gln Ala Asn Ile 515 520 525Pro Gly Ala Ile Pro His Trp Gln Leu Leu
Tyr Arg Ala Arg Glu Thr 530 535 540Tyr Gly Leu Pro Asn Thr Leu Pro
Thr Ala Trp His Asn Leu Val Tyr545 550 555 560Arg Met Arg Gly Asp
Met Gln Leu Phe Gln Thr Phe Trp Phe Leu Tyr 565 570 575His Lys Gly
His Pro Pro Ser Glu Pro Cys Gly Thr Pro Cys Arg Leu 580 585 590Ala
Thr Leu Cys Ala Gln Leu Ser Ala Arg Ala Asp Ser Pro Ala Leu 595 600
605Cys Arg His Leu Met Pro Asp Gly Ser Leu Pro Glu Ala Gln Ser Leu
610 615 620Trp Pro Arg Pro Leu Phe Cys625 63022473DNAHomo sapiens
2atcagaggaa gaggaagggg cggagctgct ttgcggccgg ccgcggagca gtcagccgac
60tacagagaag ggtaatcggg tgtccccggc gccgcccggg gccctgaggg ctggctaggg
120tccaggccgg gggggacggg acagacgaac cagccccgtg taggaagcgc
gacaatgccc 180cgctacggag cgtcactccg ccagagctgc cccaggtccg
gccgggagca gggacaagac 240gggaccgccg gagcccccgg actcctttgg
atgggcctgg tgctggcgct ggcgctggcg 300ctggcgctgg cgctggctct
gtctgactct cgggttctct gggctccggc agaggctcac 360cctctttctc
cccaaggcca tcctgccagg ttacatcgca tagtgccccg gctccgagat
420gtctttgggt gggggaacct cacctgccca atctgcaaag gtctattcac
cgccatcaac 480ctcgggctga agaaggaacc caatgtggct cgcgtgggct
ccgtggccat caagctgtgc 540aatctgctga agatagcacc acctgccgtg
tgccaatcca ttgtccacct ctttgaggat 600gacatggtgg aggtgtggag
acgctcagtg ctgagcccat ctgaggcctg tggcctgctc 660ctgggctcca
cctgtgggca ctgggacatt ttctcatctt ggaacatctc tttgcctact
720gtgccgaagc cgccccccaa accccctagc cccccagccc caggtgcccc
tgtcagccgc 780atcctcttcc tcactgacct gcactgggat catgactacc
tggagggcac ggaccctgac 840tgtgcagacc cactgtgctg ccgccggggt
tctggcctgc cgcccgcatc ccggccaggt 900gccggatact ggggcgaata
cagcaagtgt gacctgcccc tgaggaccct ggagagcctg 960ttgagtgggc
tgggcccagc cggccctttt gatatggtgt actggacagg agacatcccc
1020gcacatgatg tctggcacca gactcgtcag gaccaactgc gggccctgac
caccgtcaca 1080gcacttgtga ggaagttcct ggggccagtg ccagtgtacc
ctgctgtggg taaccatgaa 1140agcacacctg tcaatagctt ccctcccccc
ttcattgagg gcaaccactc ctcccgctgg 1200ctctatgaag cgatggccaa
ggcttgggag ccctggctgc ctgccgaagc cctgcgcacc 1260ctcagaattg
gggggttcta tgctctttcc ccataccccg gtctccgcct catctctctc
1320aatatgaatt tttgttcccg tgagaacttc tggctcttga tcaactccac
ggatcccgca 1380ggacagctcc agtggctggt gggggagctt caggctgctg
aggatcgagg agacaaagtg 1440catataattg gccacattcc cccagggcac
tgtctgaaga gctggagctg gaattattac 1500cgaattgtag ccaggtatga
gaacaccctg gctgctcagt tctttggcca cactcatgtg 1560gatgaatttg
aggtcttcta tgatgaagag actctgagcc ggccgctggc tgtagccttc
1620ctggcaccca gtgcaactac ctacatcggc cttaatcctg gttaccgtgt
gtaccaaata 1680gatggaaact actccgggag ctctcacgtg gtcctggacc
atgagaccta catcctgaat 1740ctgacccagg caaacatacc gggagccata
ccgcactggc agcttctcta cagggctcga 1800gaaacctatg ggctgcccaa
cacactgcct accgcctggc acaacctggt atatcgcatg 1860cggggcgaca
tgcaactttt ccagaccttc tggtttctct accataaggg ccacccaccc
1920tcggagccct gtggcacgcc ctgccgtctg gctactcttt gtgcccagct
ctctgcccgt 1980gctgacagcc ctgctctgtg ccgccacctg atgccagatg
ggagcctccc agaggcccag 2040agcctgtggc caaggccact gttttgctag
ggccccaggg cccacatttg ggaaagttct 2100tgatgtagga aagggtgaaa
aagcccaaat gctgctgtgg ttcaaccagg caagatcatc 2160cggtgaaaga
accagtccct gggccccaag gatgccgggg aaacaggacc ttctcctttc
2220ctggagctgg tttagctgga tatgggaggg ggtttggctg cctgtgccca
ggagctagac 2280tgccttgagg ctgctgtcct ttcacagcca tggagtagag
gcctaagttg acactgccct 2340gggcagacaa gacaggagct gtcgccccag
gcctgtgctg cccagccagg aaccctgtac 2400tgctgctgcg acctgatgct
gccagtctgt taaaataaag ataagagact tggactccaa 2460aaaaaaaaaa aaa
24733192PRTHomo sapiens 3Met Asp Gly Ser Gly Glu Gln Pro Arg Gly
Gly Gly Pro Thr Ser Ser1 5 10 15Glu Gln Ile Met Lys Thr Gly Ala Leu
Leu Leu Gln Gly Phe Ile Gln 20 25 30Asp Arg Ala Gly Arg Met Gly Gly
Glu Ala Pro Glu Leu Ala Leu Asp 35 40 45Pro Val Pro Gln Asp Ala Ser
Thr Lys Lys Leu Ser Glu Cys Leu Lys 50 55 60Arg Ile Gly Asp Glu Leu
Asp Ser Asn Met Glu Leu Gln Arg Met Ile65 70 75 80Ala Ala Val Asp
Thr Asp Ser Pro Arg Glu Val Phe Phe Arg Val Ala 85 90 95Ala Asp Met
Phe Ser Asp Gly Asn Phe Asn Trp Gly Arg Val Val Ala 100 105 110Leu
Phe Tyr Phe Ala Ser Lys Leu Val Leu Lys Ala Leu Cys Thr Lys 115 120
125Val Pro Glu Leu Ile Arg Thr Ile Met Gly Trp Thr Leu Asp Phe Leu
130 135 140Arg Glu Arg Leu Leu Gly Trp Ile Gln Asp Gln Gly Gly Trp
Asp Gly145 150 155 160Leu Leu Ser Tyr Phe Gly Thr Pro Thr Trp Gln
Thr Val Thr Ile Phe 165 170 175Val Ala Gly Val Leu Thr Ala Ser Leu
Thr Ile Trp Lys Lys Met Gly 180 185 1904888DNAHomo sapiens
4tcacgtgacc cgggcgcgct gcggccgccc gcgcggaccc ggcgagaggc ggcggcggga
60gcggcggtga tggacgggtc cggggagcag cccagaggcg gggggcccac cagctctgag
120cagatcatga agacaggggc ccttttgctt cagggtttca tccaggatcg
agcagggcga 180atgggggggg aggcacccga gctggccctg gacccggtgc
ctcaggatgc gtccaccaag 240aagctgagcg agtgtctcaa gcgcatcggg
gacgaactgg acagtaacat ggagctgcag 300aggatgattg ccgccgtgga
cacagactcc ccccgagagg tctttttccg agtggcagct 360gacatgtttt
ctgacggcaa cttcaactgg ggccgggttg tcgccctttt ctactttgcc
420agcaaactgg tgctcaaggc cctgtgcacc aaggtgccgg aactgatcag
aaccatcatg 480ggctggacat tggacttcct ccgggagcgg ctgttgggct
ggatccaaga ccagggtggt 540tgggacggcc tcctctccta ctttgggacg
cccacgtggc agaccgtgac catctttgtg 600gcgggagtgc tcaccgcctc
actcaccatc tggaagaaga tgggctgagg cccccagctg 660ccttggactg
tgtttttcct ccataaatta tggcattttt ctgggagggg tggggattgg
720gggacgtggg catttttctt acttttgtaa ttattggggg gtgtggggaa
gagtggtctt 780gagggggtaa taaacctcct tcgggacaca aaaaaaaaaa
aaaaaaaaaa aaaaaaaaaa 840aaaaaaaaaa aaaaaaaaaa aaaaaaaaaa
aaaaaaaaaa aaaaaaaa 8885211PRTHomo sapiens 5Met Ala Ser Gly Gln Gly
Pro Gly Pro Pro Arg Gln Glu Cys Gly Glu1 5 10 15Pro Ala Leu Pro Ser
Ala Ser Glu Glu Gln Val Ala Gln Asp Thr Glu 20 25 30Glu Val Phe Arg
Ser Tyr Val Phe Tyr Arg His Gln Gln Glu Gln Glu 35 40 45Ala Glu Gly
Val Ala Ala Pro Ala Asp Pro Glu Met Val Thr Leu Pro 50 55 60Leu Gln
Pro Ser Ser Thr Met Gly Gln Val Gly Arg Gln Leu Ala Ile65 70 75
80Ile Gly Asp Asp Ile Asn Arg Arg Tyr Asp Ser Glu Phe Gln Thr Met
85 90 95Leu Gln His Leu Gln Pro Thr Ala Glu Asn Ala Tyr Glu Tyr Phe
Thr 100 105 110Lys Ile Ala Thr Ser Leu Phe Glu Ser Gly Ile Asn Trp
Gly Arg Val 115 120 125Val Ala Leu Leu Gly Phe Gly Tyr Arg Leu Ala
Leu His Val Tyr Gln 130 135 140His Gly Leu Thr Gly Phe Leu Gly Gln
Val Thr Arg Phe Val Val Asp145 150 155 160Phe Met Leu His His Cys
Ile Ala Arg Trp Ile Ala Gln Arg Gly Gly 165 170 175Trp Val Ala Ala
Leu Asn Leu Gly Asn Gly Pro Ile Leu Asn Val Leu 180 185 190Val Val
Leu Gly Val Val Leu Leu Gly Gln Phe Val Val Arg Arg Phe 195 200
205Phe Lys Ser 21062203DNAHomo sapiens 6gtctgcatcc ggtggccaca
gagcaacttc ctctagaggg agctgattgg agccgggtgc 60cgctggcacc tctatgatca
ctggagtctc gcgggtccct cgggctgcac agggacaagt 120aaaggctaca
tccagatgcc gggaatgcac tgacgcccat tcctggaaac tgggctccca
180ctcagcccct gggagcagca gccgccagcc cctcgggacc tccatctcca
ccctgctgag 240ccacccgggt tgggccagga tcccggcagg ctgatcccgt
cctccactga gacctgaaaa 300atggcttcgg ggcaaggccc aggtcctccc
aggcaggagt gcggagagcc tgccctgccc 360tctgcttctg aggagcaggt
agcccaggac acagaggagg ttttccgcag ctacgttttt 420taccgccatc
agcaggaaca ggaggctgaa ggggtggctg cccctgccga cccagagatg
480gtcaccttac ctctgcaacc tagcagcacc atggggcagg tgggacggca
gctcgccatc 540atcggggacg acatcaaccg acgctatgac tcagagttcc
agaccatgtt gcagcacctg 600cagcccacgg cagagaatgc ctatgagtac
ttcaccaaga ttgccaccag cctgtttgag 660agtggcatca attggggccg
tgtggtggct cttctgggct tcggctaccg tctggcccta 720cacgtctacc
agcatggcct gactggcttc ctaggccagg tgacccgctt cgtggtcgac
780ttcatgctgc atcactgcat tgcccggtgg attgcacaga ggggtggctg
ggtggcagcc 840ctgaacttgg gcaatggtcc catcctgaac gtgctggtgg
ttctgggtgt ggttctgttg 900ggccagtttg tggtacgaag attcttcaaa
tcatgactcc caagggtgcc ctttggggtc 960ccggttcaga cccctgcctg
gacttaagcg aagtctttgc cttctctgtt cccttgcagg 1020ggtcccccct
caagagtaca gaagctttag caagtgtgca ctccagcttc ggagggcccc
1080tgcgtggggg ccagtcaggc tgcagaggca cctcaacatt gcatggtgct
agtgggccct 1140ctctctgggc ccaggggctg tggccgtctc ctccctcagc
tctctgggac ctccttagcc 1200ctgtctgcta ggcgctgggg agactgataa
cttggggagg caagagactg ggagccactt 1260ctccccagaa agtgtttaac
ggttttagct ttttataata cccttgtgag agcccattcc 1320caccattcta
cctgaggcca ggacgtctgg ggtgtgggga ttggtgggtc tatgttcccc
1380aggattcagc tattctggaa gatcagcacc ctaagagatg ggactaggac
ctgagcctgg 1440tcctggccgt ccctaagcat gtgtcccagg agcaggacct
actaggagag gggggccaag 1500gtcctgctca actctacccc tgctcccatt
cctccctccg gccatactgc ctttgcagtt 1560ggactctcag ggattctggg
cttggggtgt ggggtggggt ggagtcgcag accagagctg 1620tctgaactca
cgtgtcagaa gcctccaagc ctgcctccca aggtcctctc agttctctcc
1680cttcctctct ccttatagac acttgctccc aacccattca ctacaggtga
aggctctcac 1740ccccatccct gggggccttg ggtgagtggc ctgctaaggc
tcctccttgc ccagactaca 1800gggcttagga cttggtttgt tatatcaggg
aaaaggagta gggagttcat ctggagggtt 1860ctaagtggga gaaggactat
caacaccact aggaatccca gaggtgggat cctccctcat 1920ggctctggca
cagtgtaatc caggggtgta gatgggggaa ctgtgaatac ttgaactctg
1980ttcccccacc ctccatgctc ctcacctgtc taggtctcct cagggtgggg
ggtgacagtg 2040ccttctctat tgggcacagc ctagggtctt gggggtcagg
ggggagaagt tcttgattca 2100gccaaatgca gggaggggag gcagatggag
cccataggcc accccctatc ctctgagtgt 2160ttggaaataa actgtgcaat
cccctcaccc tgaaaaaaaa aaa 220374572DNAHomo sapiens 7atcagaggaa
gaggaagggg cggagctgct ttgcggccgg ccgcggagca gtcagccgac 60tacagagaag
ggtaatcggg tgtccccggc gccgcccggg gccctgaggg ctggctaggg
120tccaggccgg gggggacggg acagacgaac cagccccgtg taggaagcgc
gacaatgccc 180cgctacggag cgtcactccg ccagagctgc cccaggtccg
gccgggagca gggacaagac 240gggaccgccg gagcccccgg actcctttgg
atgggcctgg tgctggcgct ggcgctggcg 300ctggcgctgg cgctggctct
gtctgactct cgggttctct gggctccggc agaggctcac 360cctctttctc
cccaaggcca tcctgccagg ttacatcgca tagtgccccg gctccgagat
420gtctttgggt gggggaacct cacctgccca atctgcaaag gtctattcac
cgccatcaac 480ctcgggctga aggtgagcac tgaaggggct gcagtggagg
aggccgaaag gagtgctggg 540gctgggggct ggggctgatg ctggtgcgct
gggctcagaa tgcatccctg atggagaggg 600tggcatctac aatccatcac
tgagtttgct cccctttggg gacacccatg gctacatgcc 660accatcaccc
cattgtgacc tttgtgaagt aagaaaataa tgcagacagt gcctgaggaa
720gtcagcttgc caagcaaagg cctcatgcca caggccgctg agctaaagaa
gaagcgatgg 780cctggtgctg cctgagttac agggcaatat ctggaaggca
aaggtgtgca ctgagcttgg 840tgcactgagt cctgcccagc cccagtttgg
aaatggaggc ccaaggggtg gtggccaggg 900gttggcctgg ttcctctgct
ctgcctctga tttctcacca tgcgctcctc ccactgcaga 960aggaacccaa
tgtggctcgc gtgggctccg tggccatcaa gctgtgcaat ctgctgaaga
1020tagcaccacc tgccgtgtgc caatccattg tccacctctt tgaggatgac
atggtggagg 1080tgtggagacg ctcagtgctg agcccatctg aggcctgtgg
cctgctcctg ggctccacct 1140gtgggcactg ggacattttc tcatcttgga
acatctcttt gcctactgtg ccgaagccgc 1200cccccaaacc ccctagcccc
ccagccccag gtgcccctgt cagccgcatc ctcttcctca 1260ctgacctgca
ctgggatcat gactacctgg agggcacgga ccctgactgt gcagacccac
1320tgtgctgccg ccggggttct ggcctgccgc ccgcatcccg gccaggtgcc
ggatactggg 1380gcgaatacag caagtgtgac ctgcccctga ggaccctgga
gagcctgttg agtgggctgg 1440gcccagccgg cccttttgat atggtgtact
ggacaggaga catccccgca catgatgtct 1500ggcaccagac tcgtcaggac
caactgcggg ccctgaccac cgtcacagca cttgtgagga 1560agttcctggg
gccagtgcca gtgtaccctg ctgtgggtaa ccatgaaagc acacctgtca
1620atagcttccc tccccccttc attgagggca accactcctc ccgctggctc
tatgaagcga 1680tggccaaggc ttgggagccc tggctgcctg ccgaagccct
gcgcaccctc aggtacttat 1740cgtccgtgga aacccaggaa gggaaaagaa
aggtgaatga aagtgaaggg agaagggaac 1800ctggggcatt gtctctgatt
gctctagcat gagtccttag tgctcttcat ttggctcccc 1860taatctgact
cctccttccc tttctactgt tttgccgcac caggcttttt tttttttttt
1920ttttttagtt tagtttttgt agagacaaga tcttgctatg ttgcccaggc
tggtctcaaa 1980cacctaacct caagcaatcc tcccgcctcg gcctcccaaa
atgctgggac cacaggcatc 2040agctactgct cctggccctc cctttttttt
tttttttttt tttttttttt tgagatggaa 2100tcttgctctg ttgcccaggc
tggagtgcag tggcaccatc tcagctcact acagcctcca 2160cctcctgggt
tcaagcaatt ctgcctcagc ctcccaagta cctgggacta caggtgcacg
2220ccaccacacc cagctaattt ttgtattttt agtagagatg gggtttcacc
atgttggcca 2280agatggtctt gatctcctga cctcatgatc tgcccacctc
ggcctcccaa agtgctggga 2340ttacaggcat gaaccactgc acccagcttt
ccagccctcc ctttctactc ttatctccag 2400ccaccctcct tcaaaggtct
ggcagcataa cctctctatg ccccagctgt gtctttgctc 2460atgttggccc
tctggaaatg atttccccct tttttttaag tgctccagtt tttcccacct
2520tatccatccc atgtcatctt ccctctgtgt ggtccttgct tcccattcta
gctaactctt 2580atccctcccc catactcctg gagccctctg ccctcagagt
cttttgtgtc acacagaccc 2640aataattaga actgtttggt ctctggctag
actgtgagct ccttgcaggt ggggaagatg 2700tcatgtatgc ttttaccctc
cacccaaatg cccagcacag gaggaccagg attggaacaa 2760gtgttgacct
ctcatgttta ctttgtttca gaattggggg gttctatgct ctttccccat
2820accccggtct ccgcctcatc tctctcaata tgaatttttg ttcccgtgag
aacttctggc 2880tcttgatcaa ctccacggat cccgcaggac agctccagtg
gctggtgggg gagcttcagg 2940ctgctgagga tcgaggagac aaagtgaggg
ccagtagtgg gaacacggtg gtgctggggg 3000acaagcaggc tcctgttgag
ctggagcacc tctgggcaca gaagttttat tttcctggca 3060ttcccaacaa
gtgttccctg gggattcagc tcatggtcac tgttgaaagc cttcattcag
3120tccccctttc tctagccagg gctgcctgga cccctggatg ccctgattac
catccttaat 3180tctccctact aggtgcatat aattggccac attcccccag
ggcactgtct gaagagctgg 3240agctggaatt attaccgaat tgtagccagg
taggacggag atgagggtgg gaatagggac 3300agggtgagtg tctgaaggct
gaaaattccc ttgagcatct caccatccct gttgtcccat 3360ggagtgggga
ggctcctcac tagaacaggt tggagaaaga gggcatccta tctccccaga
3420tgtcttccta cccctcccta gaatcttctg aatgtagtac cttctggcca
ggtatgagaa 3480caccctggct gctcagttct ttggccacac tcatgtggat
gaatttgagg tcttctatga 3540tgaagagact ctgagccggc cgctggctgt
agccttcctg gcacccagtg caactaccta 3600catcggcctt aatcctggtg
agtgaggcag aagggagcct cccttatcct ggagttggtg 3660ggatagggga
aggaggttgg agccagagcc tgcaaagcat gggcaggatg tgtggcccct
3720ccctggagtt acccttgctc cttgcccctc cagtcagccc cacatccttg
caggttaccg 3780tgtgtaccaa atagatggaa actactccgg gagctctcac
gtggtcctgg accatgagac 3840ctacatcctg aatctgaccc aggcaaacat
accgggagcc ataccgcact ggcagcttct 3900ctacagggct cgagaaacct
atgggctgcc caacacactg cctaccgcct ggcacaacct 3960ggtatatcgc
atgcggggcg acatgcaact tttccagacc ttctggtttc tctaccataa
4020gggccaccca ccctcggagc cctgtggcac gccctgccgt ctggctactc
tttgtgccca 4080gctctctgcc cgtgctgaca gccctgctct gtgccgccac
ctgatgccag atgggagcct 4140cccagaggcc cagagcctgt ggccaaggcc
actgttttgc tagggcccca gggcccacat 4200ttgggaaagt tcttgatgta
ggaaagggtg aaaaagccca aatgctgctg tggttcaacc 4260aggcaagatc
atccggtgaa agaaccagtc cctgggcccc aaggatgccg gggaaacagg
4320accttctcct ttcctggagc tggtttagct ggatatggga gggggtttgg
ctgcctgtgc 4380ccaggagcta gactgccttg aggctgctgt cctttcacag
ccatggagta gaggcctaag 4440ttgacactgc cctgggcaga caagacagga
gctgtcgccc caggcctgtg ctgcccagcc 4500aggaaccctg tactgctgct
gcgacctgat gctgccagtc tgttaaaata aagataagag 4560acttggactc ca
457286939DNAHomo sapiens 8tcacgtgacc cgggcgcgct gcggccgccc
gcgcggaccc ggcgagaggc ggcggcggga 60gcggcggtga tggacgggtc cggggagcag
cccagaggcg ggggtgaggc gggaggcaga 120cgggcgggag gagggcgagc
cccctcgccg gcccgtccgg gatccttcct accggcctgg 180ggctgtgcga
tctccaagca ctgaggggca gaaactcccg gatcgggcgc tgccagcctc
240cagtcccctc cgtcctcgga ggttcctggc tctctgatcc ccgtgtcccg
atccctgcct 300ctctggcgct ctcggaccct cgagaaccag gggatctcgg
aagccaagcc cccgggcagg 360cccgggcttg tcgcccgcac cacttcctgc
ctctggcact ggtgggaggg gcgggtctcg 420cctctgcccc ctcaggccag
gggtctggat gcatatagcg ttcccctagc ctctttcccc 480ggggagaatg
taggatacag gcccagcctc ctggcctttc tccatcaggg actcagttgt
540ctgggccccc ccgtcacttt atctgctagg gtcccagaag tccagggtcc
ccagctctgt 600cctccctcag gggccgtgag tctccacagt ctcctgatcc
cctagaaccc aagagtccag 660gtacctcttc ccttcctttc tcctctaggg
cccaccagct ctgagcagat catgaagaca 720ggggcccttt tgcttcaggg
gtgagtttga ggtctgatta ttgtggcaca gatttgagga 780gtgacacccc
gttctgattc tgcaccctca ctccatcccc actctagttt catccaggat
840cgagcagggc gaatgggggg ggaggcaccc gagctggccc tggacccggt
gcctcaggat 900gcgtccacca agaagctgag cgagtgtctc aagcgcatcg
gggacgaact ggacagtaac 960atggagctgc agaggtgtgg gcccctgagg
acccagaagt ccagccactg ggctccttca 1020ggacacagga ctctcagccc
cgcattctcc tcctccccta agaactagga gtctgggccc 1080cacaactcag
cgcaaacatt ccggactccc agccctcctc tctgccagga tcttaaaacc
1140ctccttcagg gagtcatttt tcccaccttc ctaaatgtct gtcttgtccc
cttcccttgt 1200cccccgttgg cctgttgctt ttcatttcag cctggcttgg
ggctcagtct ccttatcttt 1260agtgtgcggt ggatgcggga attttccacc
atcagcctga tgcctgctcc ccggcactgg 1320ttctcctctc tcctgcagga
tgattgccgc cgtggacaca gactcccccc gagaggtctt 1380tttccgagtg
gcagctgaca tgttttctga cggcaacttc aactggggcc gggttgtcgc
1440ccttttctac tttgccagca aactggtgct caaggtgggc agctgcaggg
cagtgagccc 1500agggatgctc cccctcagat ctgtgaggac ctggggatcg
tggtatcaac cccctgcagt 1560ggcccagtga ccacagaggg catggagaga
gatggctgtg cactgggtgt ctgctccttc 1620ttttattcat tcaacaagca
tttactggac ctgctatgtg ccaggcctat acctggcacc 1680tgggacacag
cactgtacaa agcaggctac atccctgctc tcagggagtt cacgtgcagg
1740ggtgaagtaa agtgggcagt gtgatttagc agagtggtca ggaaagattt
ctattttttt 1800tttttttttt tttgagatgg agttttgctc ttgttgccca
ggcttgagtg caatggcatg 1860atcttggttc actgcaacct ctgcctccca
ggttcaagcg attctcctgc ctcagcttcc 1920tgagtagctg ggattatggg
tgtgcaccat tatccctggc tttttttttt tttttttttt 1980tttttgtatt
tttagtagag acgggtttca ccatgttggt caggctggtc ttgaactcct
2040gacctcaagt gatccacctg ccttggcctc ccaaagtgct gggattacag
gcatgagcca 2100ccgcaacaag ccaggaaaga cttctaaggg caggtgacat
caaagagcag gtgacattaa 2160agccaaagct agaatgataa gaagcatgca
gtgatctata gtgatcgggg ggaagaggca 2220tctggtagag ggaacagcaa
gtgcaaaggc cctgaggtag gaccaagcct catcttttga 2280cagtagggag
gaggccagtg ctgttggaac agagtgaact ggggagaggg tgggaaagga
2340aggcacagtt gggcaggggc agattgtgtg gagtttttcg ggctgctgga
aagacttttt 2400cttttctttt tttttttttt tttttttttt tttgagacag
agtctcactt tgttgcccag 2460gctggagtgc aatggcgcca tctcggctca
ctgcaacctc tgcctcccgg gttcaagtga 2520ctctcatgct ttagcctccc
aagtagctag aattacaggc acacaccacc atgcctggct 2580agtttttgta
tttttagtag agacggagtt tcgccatgtt ggccaggctg gtctcaaact
2640cctggcctca agtgatccgc ccaccttggc ctcccaaagt gctgggatta
caggcgtgaa 2700ccactgcacc cagcctggaa agactttaac tttactctga
gtgtgatggg agtgattggc 2760tggttttaaa tacggaagcg acaagacctg
atttataact ttaagagatt attctagcaa 2820gtatagatgc cccttgactt
gcaatggtgt tacatcctag taatcccatc ataaattgaa 2880aataacataa
gttgaaaatg cattcaatgc cccgataaac ccatagtaag gtcaaaattg
2940taagtcaaac cgtcataagt tggggactgt ctgtatagca aaatgttaat
tgtagaatct 3000aattataggt ggcggctata tggcttttaa ctgtgaaatt
cttttaactt ttcattatga 3060agattctcat aagaaaatgt ggtgggggtg
gtggtgaaat gctcctggct gttgttggcc 3120aaaagagatc atgaggcaca
agggcagaag cgaggatcct ggagaggtgg cacctgtcat 3180agtcttgctg
aaagatgaca agccctggtg gtagcagcag aggtgcgggg ggggcatttt
3240tttttttaag aggtagggtc ttgctctgtt ggccaggctg gagtgcagta
gtgatcatag 3300ctcactgcag cctcaaaccg ctggggtcaa gcagttctct
cgcctcagtc tccagagtag 3360ctgagactac aggagcatgc caccacgccc
cactaactgt tgcattagtc tttttctata 3420gagacggggt ctcgctatgt
tgtccaggct ggtctccaac agggagggat atttcttttt 3480ggaagatttt
tttttttttt tttttttttt tttgatacag ggtctcgctc tgttaccaag
3540gctggaatgc agtggcatga ccttggctca ctgcagtctc cacctcctgg
gttcaagcaa 3600ttctacctca gcctcctgag aagctgggat tacaggctct
ccccaccaca ccagcaaatg 3660ggagggatat ttctttcttt ctttcttttt
tttttttcct gagacggagt ctctctcggt 3720tgcacccagg ctggagtgca
gtggcgcgat ctcagctcac tgcaacctcc acctcctggg 3780tttaagcgat
tctcttgcct cagtctcccg agtagcttgg gattacaggc gtccgccacc
3840acacccagct aatttttgca tttttagtag agatggggtt tcaccatgtt
ggccaggctg 3900gtctcgaact ccttacctca ggtgatccgc ctgcctcggt
ctcccaaagt gctgggatta 3960caggcgtgag ccaccgtgct cagctgagag
ggatatttct tgatgtgttt tcaagattga 4020gctgatgggg cctgaacgtc
cgagatgagg ggaatagcag tgcaggtgat ggtggcacca 4080cctacagagc
ggggatgata gaatagaagt ggccagataa aggctgcagg agaagtcttg
4140ggagttggga gagcaggtcg gggtccatgg tcaggggttg atcttctctg
gtccagaaaa 4200gtcctctctg gctgggcgtg gtggctcacg cctgtaatcc
cagcactttg ggaggccgag 4260gcagggggat catgaggtca ggagatcgag
accatcctgg ctaacatggt gaaaccccgt 4320ctctactaaa aatacaaaaa
attagccggg catggtggtg ggcacttgta gtcccagcta 4380ctcgggaggc
tgaggcagaa gaatggcgtg aactgggagg cggagtttgc agtgagctga
4440gattgcacca ctgcactcca gcctggagcg acagagtgag actccgtctc
aaaaaaaaaa 4500aaaaaaaaaa aagaaaagtc ctctctgggg aagtgacatt
tgccctgaga gctgaagggt 4560aagaatttgc ttcgtcgagg cctgtttagg
cggaaacagg agtacatgaa gaagtcccga 4620ggcaggaaga atttgatggg
aatttaaaaa attaaaaaaa aaaaaaaaaa tggggctggg 4680catggtggct
cacacctgta atcccggcac tttgggaggc tgaggcatgc ggatcaccta
4740aggccaggag tttgagacca gcctgaccaa catggtgaaa ccttgtctgc
actaaaaatt 4800caaaaaaaaa aaaaaaaata gcccggtgtg gtggcggatg
cctgtaatac cagctgctta 4860ggaggctcag gcaggaggat cacttaaatc
tgggaggcgg aggttgcaat gagccgagac 4920tgcactattg tactccagcc
tgggcaacaa gatcaaaact ctatctcaaa aaaaaaaaaa 4980aaaattagcc
aggcatgttg gcaggcacct gtaatcccaa ccctttggga ggctggggca
5040ggagaattgc ttgaacccag aaggcaaagc tttcagtgag ccgagattgc
gccactgcac 5100tccatcctgg gtgtcagagc aagactccat cttaaaaaaa
aaaaatggaa gcagctcagc 5160gaggcacaaa acaggaagtg gaaaggtgga
gtgaggtcag gccaaagcct gcacacaggg 5220cttgtgggct gcactgtgcc
ttcgggtctt catcctgagg gtactgggga gccacagaag 5280gctcaggggt
ggggcagttg agagtaacat tatcttgttt acaattttat tttttttatt
5340tatttatttt ttgagacgga ttcttgctct attgtccagg ctggcgtgaa
atggcgtgat 5400ctgggctcac tgcaacctct gcctcctggg ttcaagcgat
tcacctgcct cagcatccca 5460aggagctggg attacaggtg cctgccacca
cacccagcta atttttgtat ttatttattt 5520tgagatggag ttttgctctt
gttgcccagg ctggagtgca atggcgcaac ctcggctcac 5580tgcaacctcc
gcctcccggg ttcaagcaat tctcctgcct cagactccca agtagctggg
5640attacaggca tgtgccacca cgcccggcta attttgtatt tttagtagag
atggcattac 5700tccgtattgg tcaggctggt cttgaactcc cgacctcaag
tgatccgcct gccttggcct 5760cccaaagtgc tgggattaca ggcatgagcc
gccgcacctg gccatgttta caatttttga 5820agccgacttc aattgtgggt
ggcagaaatc tttgagggga ggcaaagaat tgacaaagga 5880ggtttggggc
cactatctcc aggcagtggg gacaaggttc agtccctaac gcccactcca
5940ctccccacag gccctgtgca ccaaggtgcc ggaactgatc agaaccatca
tgggctggac 6000attggacttc ctccgggagc ggctgttggg ctggatccaa
gaccagggtg gttgggtgag 6060actcctcaag cctcctcacc cccaccaccg
cgccctcacc accgcccctg ccccaccgtc 6120cctgcccccc gccactcctc
tgggaccctg ggccttctgg agcaggtcac agtggtgccc 6180tctccccatc
ttcagatcat cagatgtggt ctataatgcg ttttccttac gtgtctgatc
6240aatccccgat tcatctaccc tgctgacctc ccagtgaccc ctgacctcac
tgtgaccttg 6300acttgattag tgccttctgc cctccctgga gcctccactg
cctctggaat tgctcaagtt 6360cattgatgac cctctgaccc tagctctttc
cttttttttt ttttccccac tgagaagggg 6420tctcgctatg ttgcccaggt
tggtctcgaa ctcctggcct caagcgatcc tcccgcctca 6480gcctctcaaa
gtgctgggat tacaggtgtg agccaccatg cctggcctga gtccagctct
6540ttaatgcccg ttcatctcag tcccctgccc gcaatcctgc cttctggcct
cctccgtccc 6600tgatcccgcc tctgcctgcc caggggctgc ccctggccga
gtcactgaag cgactgatgt 6660ccctgtctcc aggacggcct cctctcctac
tttgggacgc ccacgtggca gaccgtgacc 6720atctttgtgg cgggagtgct
caccgcctca ctcaccatct ggaagaagat gggctgaggc 6780ccccagctgc
cttggactgt gtttttcctc cataaattat ggcatttttc tgggaggggt
6840ggggattggg ggacgtgggc atttttctta cttttgtaat tattgggggg
tgtggggaag 6900agtggtcttg agggggtaat aaacctcctt cgggacaca
693993000DNAHomo sapiens 9gtctgcatcc ggtggccaca gagcaacttc
ctctagaggg agctgattgg agccgggtgc 60cgctggcacc tctatgatca ctggagtctc
gcgggtccct cgggctgcac agggacaagt 120aaaggctaca tccagatgcc
gggaatgcac tgacgcccat tcctggaaac tgggctccca 180ctcagcccct
gggagcagca gccgccagcc cctcgggacc tccatctcca ccctgctgag
240ccacccgggt tgggccagga tcccggcagg taagctggaa gggtcttgtc
catcctccca 300gatctcagca gccccagccc cagggtgggg cagggagcct
gccgggagcc gggtggggaa 360ggggaagctc aaggcttccc tgggcaggtc
tgccgccccg gctggggacc tgatcctgcc 420atgcctgcct ctggctgccc
ctcacagctt cccctcttgg cccagccctg gatgccggag 480aactgtaaga
actgggtcct ttaacagtct gggagatggg agtggaggtc agagccaagg
540tcaagggcag agagagaact ttctcagcgc ttgctgctgc ccaacatccc
tagactgggt 600ccagggcctg gccaggcatg tatccctggg caacattcat
cggggcccag caagcccagg 660aagtcggggg tggctcccct caccgggaat
ttaggccact tggatggggg aggcagagct 720aggcctgagt cagcataggt
tgctggcctt ggtgggtgtt ctgaggctct acctgctccc 780ctcggaagcc
tggggtgttg gtagagggag ttggaggtgc agtcagcatc ctccagccct
840actgtcctgg gggtgccggg tcctggagac tggggaagaa ggaaggccat
cttatgtaag 900gagctacggg gggtgggagg caagcaaaac tctttttttt
tgttttttga aatggagtct 960cgctctgttg cccaggctgg agtgcagtgg
cgcaatctcg gctgaccgca acctccgcct 1020ccaaggttca agcgattctc
ctgcctcagc ctcccgagta gctgggacta caggcgcacg 1080ccaccatgcc
cagctaattt ttgtattttt agtagagatg gggtttcatt atgttggcca
1140agctggtctt gaacttctga cctcgtgggc cactatgccc ggctgcaaag
ttctgtttta 1200acaaggcctt gcccctagag gtggaggaga ggaaggtctg
ccttcaccct gtccctgtcc 1260ggcagatcga ggaggagtgg ggagctgggt
gagggcacag gtggtccagc cctcctccac 1320cccttcttga gagctcttgg
ggcactttcg aaaacactcc caggcctagc ggaaggaggg 1380tgggcgaagg
tccccaggcc ctgggcggtg ggggtggggc tgtgtgcttg gcccagggtg
1440gggctgcaca ccccctccct ctgggatagg aggagggcgc tctccttctg
agggctggag 1500gctgcctggg gaaatggggc tctgggaggg gtgcaaactg
aaagtgaaac agctgacatc 1560caggaaacac tcgccctgat gaggggtcac
agcaggttgg ggctgcggtc aggaccaggc 1620aaagaggaaa attggggccg
gggacagaag accaggtgtg tggtgggagt acgaggcagg 1680ttatggggct
tcaaagaagg ccctgatcct gagggctccc tccggtcact gcaaggcagc
1740agtggggaag gcacagacag gaggtaaata gggaaagttg ccctgagaaa
gaacacactc 1800tgaggtccac aaactggaaa agaaatcttg catgcgtgtt
gagtacatgg actcacggag 1860attcagacaa acaacctgac tttccgtgac
taacgatgtg acctcgggca ctcaactctt 1920tgtgcctcac ttttcctgcc
tgtaaagtgg gtatgatggc gctcaccctg ctgggttcat 1980gtgagtttcc
agtgttcacc acccacagag tgctcctaag tgggagagta tatcttaggc
2040tctcaggaaa tgtttgcggc taacagccca gagttaaaaa acaggtgtgt
tctggccagc 2100cagagggaag tagggcctct gaggacagcc ttcatgggcc
attggctggg cagtggctcg 2160cttgcaataa gcatgtgctg ggtgggctgc
aggaggcccc aggaacagct aaaaaccccc 2220caggctcttg ccccaggagt
ggcatgaact tgagagccag cgggcactgc tgcagccaca 2280ccctcctcga
tggtgcagat acctcagtct gcccttggct gcctcacctt cttaccctgt
2340ctccctcaaa gagggagtgt tcagtaagtt gtttcctccc agcagacttc
actgggaccc 2400atgctggagt aagaataaaa agtcccagag gaggccaggc
acggtggctc acacctgtaa 2460tcccagcact gtggatggcc gaggcagact
cacgaggtca ggagtttgag accggcctgg 2520ccaaagtccc agaggactaa
gggcctttct gggaatgggg gatcctctct cctatgtgga 2580catggcaacc
tgtatggggt ccccagtcac aggtctgtgc tcacccccat ctctgctttt
2640tctcgccctt ccccgcaggc tgatcccgtc ctccactgag acctgaaaaa
tggcttcggg 2700gcaaggccca ggtcctccca ggcaggagtg cggagagcct
gccctgccct ctgcttctgg 2760taagggtctt cctgccccct cacccatccc
ataaccatga gtgctgtcgt gaggatggaa 2820ggagcaggac tcaggcaggc
tccttcgcct cggttcaccc actgtgggtg gggaatactc 2880ttccccaccc
acgggctcag aggctggagc tgctgtcaag gttaagccca ggagggggag
2940gagtctggac tggggagggc ctggaggttg ggagaggcca ggaagtgagt
gtaaggtagg 3000
* * * * *